格列苯脲联合胰岛素泵双波疗法对GDM疗效及患者血清Vaspin、Chemerin的影响

Effectiveness of glibenclamide combined with insulin pump dual-wave therapy and its influence on the levels of Vaspin and Chemerin in patients with gestational diabetes mellitus

目的:探讨格列苯脲联合胰岛素泵双波疗法对妊娠期糖尿病(GDM)血清Vaspin及Chemerin水平的影响。方法:选取2015年10月至2017年10月陕西延安市安塞区人民医院收治的100例GDM患者作为研究对象,按照随机数字表法分为对照组和观察组,每组50例。对照组使用胰岛素泵双波疗法治疗,观察组使用格列苯脲联合胰岛素泵双波疗法治疗。对比两组患者血糖指标、血糖达标时间、每日胰岛素用量、低血糖发生情况、母婴结局及治疗前、后血清Vaspin及Chemerin水平。结果:治疗后,两组患者血清Vaspin及Chemerin水平均明显降低,且观察组显著低于对照组(P<0.05)。两组低血糖发生率、羊水过多、胎膜早破、剖宫产、妊高症、巨大胎儿及新生儿呼吸窘迫比较,差异均无统计学意义(P>0.05),观察组血糖指标、血糖达标时间、每日胰岛素用量、新生儿早产及新生儿低血糖低于对照组(P<0.05)。结论:格列苯脲联合胰岛素泵双波疗法治疗可改善胰岛素抵抗,有助于控制GDM患者的血糖,降低血清Vaspin及Chemerin水平,安全、可靠,值得临床推广应用。

Objective:To explore the effectiveness of glibenclamide combined with insulin pump dual-wave therapy and its influence on the serum levels of Vaspin and Chemerin in patients with gestational diabetes mellitus(GDM).Methods:100 GDM patients treated in our hospital from October 2015 to October 2017 were selected,and randomly divided into a control group and an observation.The patients in the control group were treated with insulin pump dual-wave therapy,and those in the observation group were treated with glibenclamide and insulin pump dual-wave therapy.The blood glucose,blood glucose compliance time,daily insulin dosage,hypoglycemia in the course of treatment,the maternal and infant outcomes as well as the serum Vaspin and Chemerin levels were compared between the two groups.Results:After treatment,the serum Vaspin and Chemerin levels were descended in both group,and the changes were more marked in the observation group(P<0.05).There was no significant difference in the incidence of hypoglycemia,amniotic fluid,premature rupture of membranes,cesarean section,pregnancy-induced hypertension,macrofetus and neonatal respiratory distress between the two groups(P>0.05),and the blood glucose,blood glucose compliance time,daily insulin dosage,neonatal premature delivery and neonatal hypoglycemia in the observation group were lower than those in the control group(P<0.05).Conclusion:Glibenclamide combined with insulin pump dual-wave therapy was safe and effective in the treatment of GDM.It could improve insulin resistance and blood glucose level,and reduce serum Vaspin and Chemerin levels in GDM patients.