妊娠期糖尿病胰岛素泵持续强化治疗对新生儿脐带血IGF-Ⅰ水平的影响

Continuous Intensive Insulin Pump Therapy on Gestational Diabetes Mellitus to Effect on Umbilical Cord Blood IGF-Ⅰ of Neonates

目的探讨妊娠期糖尿病(GDM)胰岛素泵持续强化治疗对新生儿脐带血胰岛素样生长因子-Ⅰ(IGF-Ⅰ)水平的影响。方法将80例GDM患者随机分为A组与B组各40例,分别予胰岛素泵持续强化治疗、胰岛素多次皮下注射进行治疗,孕妇分娩前检测空腹血糖(FBG)、餐后2h血糖(2h PBG)、糖化血红蛋白(Hb Alc)水平,新生儿出生后检测脐带血IGF-Ⅰ水平和出生体重,并与同期40例正常孕妇对照组作比较。结果A组与对照组孕妇分娩前FBG、2h PBG、Hb Alc水平无明显差异(P>0.05),均明显低于B组(P<0.05)。A组与对照组新生儿脐带血IGF-Ⅰ水平、出生体重及血糖发生率无明显差异(P>0.05),均明显低于B组(P<0.05)。A组与对照组大于胎龄儿、巨大儿发生率无明显差异(P>0.05),均明显低于B组(P<0.05)。经Pearson相关分析,新生儿脐带血IGF-1水平与出生体重存在线性关系。结论 GDM胰岛素泵持续强化治疗可有效控制孕妇血糖水平,改善新生儿脐带血IGF-Ⅰ水平,减少新生儿巨大儿的发生率,对改善新生儿预后有积极影响。

OBJECTIVE To explore continuous intensive insulin pump therapy on gestational diabetes mellitus （GDM） to effect on umbilical cord blood IGF- I of neonates. METHODS 80 patients with GDM were divided into group A and group B randomly and each with 40 cases, and were separately given continuous intensive insulin pump therapy and subcutaneous insulin injections therapy. The levels of fasting blood glucose （FBG） , postprandial 2H blood glucose （2hPBG） and glyeosylated hemoglobin （HbAlc） of prenatal women were measured ,and the levels of umbilical cord blood IGF- I and birth weight of newborns were measured, and compared with control group of 40 nor- mal pregnant women in the same period. RESULTS There were no significant differences in FBG, 2hPBG and HbAlc between the group A and the control group （P 〉 0.05 ） , which were both significantly lower than those in the group B （ P 〈 0. 05 ）. There were no significant differences in umbilical cord blood IGF- I , birth weight and blood sugar between the group A and the control group （P 〉 0. 05 ）, which were both significantly lower than those in the group B （P 〈 0. 05 ）. There were no significant differences in large for gestational age and macrosomias between the group A and the control group （ P 〉 0. 05 ）, which were both significantly lower than those in the group B （ P 〈 0. 05 ） . Analyed by pearson correlation, there was a linear relationship between umbilical cord blood IGF-1 and birth weigh in neonates. CONCLUSION Continuous intensive insulin pump therapy in treatment with GDM can control the blood glucose of pregnant women effectively, and improve umbilical cord blood IGF- I of neonates, and reduce mac- rosomias;which have a positive impact to improve the prognosis of neonates.