门冬胰岛素及地特胰岛素在妊娠期糖尿病中的应用观察

Observation of the application of insulin aspart and insulin detemir in the treatment of gestational diabetes

目的:探讨门冬胰岛素及地特胰岛素在妊娠期糖尿病中的应用效果。方法:选择2018年2月—2020年1月江西省妇幼保健院收治的妊娠期糖尿病患者160例,依据随机对照原则分为两组,每组80例。观察组给予门冬胰岛素+地特胰岛素治疗,对照组给予门冬胰岛素+诺和灵N治疗。两组均治疗4周即1个疗程。比较两组治疗后空腹血糖(FBG)和餐后2 h血糖(2 h PG)达标时间、治疗前后血糖指标水平与胰岛功能变化情况以及母婴不良情况发生率。结果:观察组FBG及2 h PG的达标时间均短于对照组(P均<0.05)。治疗后观察组FBG、2 h PG、糖化血红蛋白(HbA1c)和胰岛素抵抗指数(HOMA-IR)水平均低于对照组(P均<0.05),而胰岛β细胞功能指数(HOMA-β)则高于对照组(P<0.05)。观察组的母婴不良情况包括早产、子痫前期、高血压、剖宫产、巨大儿、新生儿呼吸窘迫、新生儿黄疸和新生儿低血糖的发生率也均低于对照组(P均<0.05)。结论:门冬胰岛素联合地特胰岛素治疗妊娠期糖尿病血糖控制效果好,能够改善胰岛功能和母婴预后,值得临床推荐。

Objective:To investigate the application effect of insulin aspart and insulin detemir in the treatment of gestational diabetes mellitus.Methods:One hundred and sixty patients with gestational diabetes mellitus admitted to Jiangxi Provincial Maternal and Child Health Care Hospital from February 2018 to January 2020 were selected and according to the principle of random control,divided into two group with 80 cases each.The observation group was treated with insulin aspart and insulin detemir,and the control group was treated with insulin aspart and novolin N.Both groups were treated for 4 weeks i.e.,a course of treatment.The fasting blood glucose(FBG)and the time of reaching the standard for 2 h postprandial blood glucose(2 h PG)after treatment,changes in blood glucose index levels and islet function levels before and after treatment,and the incidence of the mother and infant adverse events were compared between the two groups.Results:The time of reaching the standard of FBG and 2 h PG in the observation group was shorter than that in the control group(P<0.05).After treatment,FBG,2 h PG,HbA1c and HOMA-IR levels in the observation group were lower than those in the control group(P<0.05),however,HOMA-βin the observation group was higher than that in the control group(P<0.05).The incidences of maternal and infant adverse conditions in the observation group,including premature birth,preeclampsia,hypertension,cesarean section,macrosomia,neonatal respiratory distress,neonatal jaundice,and neonatal hypoglycemia,were also lower than those in the control group(all P<0.05).Conclusion:Insulin aspart combined with insulin detemir has a good effect on blood glucose control in the treatment of gestational diabetes,and can improve islet function and maternal and infant prognosis,which is worthy of clinical recommendation.