二甲双胍联合胰岛素泵皮下注射对妊娠期糖尿病患者妊娠结局及血清CysC、CRP、Betatrophin水平的影响

The influence of metformin combined with subcutaneous insulin pump injection on pregnancy outcomes and serum levels of CysC, CRP and betatrophin of women with gestational diabetes mellitus

目的:探讨二甲双胍联合胰岛素泵皮下注射治疗妊娠期糖尿病效果及对妊娠结局和血清胱抑素C(CysC)、C反应蛋白(CRP)、促代谢因子(Betatrophin)水平影响。方法:选取2017年2月-2018年2月本院确诊的126例妊娠期糖尿病患者,随机数表法分为观察组(n=65)和对照组(n=61),对照组采用胰岛素泵皮下注射治疗,观察组采用二甲双胍联合胰岛素泵皮下注射治疗。观察两组血糖指标[空腹血糖(FBG)、2hPG、糖化血红蛋白(HbAlc)],血清Cys C、CPR、Betatrophin水平,妊娠结局。结果:治疗后,观察组FBG(3.98±0.93mmol/L)、2hPG(5.90±0.70)mmol/L、HbAlc(5.18±0.65%)均低于对照组(6.05±1.02mmol/L、9.02±0.85mmol/L、6.07±0.84%),Cys C(0.71±0.15mg/L)、CPR(1.43±0.31pg/L)、Betatrophin(572.39±87.61pg/ml)水平均低于对照组(0.92±0.20mg/L、 2.16±0.46pg/L、703.21±97.82pg/mL),孕妇妊娠不良情况(6.2%)低于对照组(37.7%),新生儿并发症发生率(12.3%)低于对照组(37.7%)(均P<0.05)。结论:二甲双胍联合胰岛素泵皮下注射可有效控制妊娠期糖尿病患者血糖水平,改善妊娠结局,减少产妇及新生儿并发症,降低血清CysC、CRP、Betatrophin水平。

Objective:To explore the influence of metformin combined with subcutaneous insulin pump injection on pregnancy outcomes and serum levels of Cystatin C(CysC),C-reactive protein(CRP)and betatrophin of pregnant women with gestational diabetes mellitus(GDM).Methods:126 pregnant women with GDM were selected as research objects from February 2017 to February 2018,and they were divided into the observation group(n=65)and the control group(n=61)by random number table.The women in the control group were treated with subcutaneous injection with insulin pump,while the women in the observation group were treated with metformin combined with insulin pump for subcutaneous injection.The blood sugar index,such as levels of FBG,2 hPG,HbAlc,serum levels of Cys C,CPR,and betatrophin,adverse pregnancy outcomes of pregnant women,and incidence of neonatal complications were compared between the two groups.Results:After treatment,the levels of FBG,2 hPG,HbAlc,Cys C,CPR,and betatrophin of women in the observation group were 3.98±0.93 mmol/L,5.90±0.70 mmol/L,5.18±0.65%,0.71±0.15 mg/L,1.43±0.31 pg/L,and 572.39±87.61 pg/mL,respectively,which were significant lower than those(6.05±1.02 mmol/L,9.02±0.85 mmol/L,6.07±0.84%,0.92±0.20 mg/L,2.16±0.46 pg/L,and 703.21±97.82 pg/mL,respectively)of women in the control group(P<0.05).The adverse pregnancy outcomes of women in the observation group was 6.15%(4/65),which was also significant lower than that(37.7%,23/61)of women in the control group(P<0.05).The incidence of neonatal complications in the observation group was 12.30%(8/65),which was significant lower than that(37.7%,23/61)in the control group(P<0.05).Conclusion:Metformin combined with insulin pump subcutaneous injection can effectively control the blood sugar level of preganet women with GDM,can improve their pregnancy outcomes,can reduce the complication rate of mothers and newborns,and can decrease serum levels of CysC,CRP and betatrophin.