门冬胰岛素注射液治疗妊娠期糖尿病患者的效果及其机制

Effect and mechanism of Insulin Aspart Injection in the treatment of gestational diabetes mellitus patients

目的探讨门冬胰岛素治疗妊娠期糖尿病(GDM)患者的效果。方法选取2016年2月—2018年10月于南京医科大学附属淮安第一医院收治的120例GDM患者作为研究对象,采用随机数字表法分为联合组和对照组,各60例,两组均给予二甲双胍进行控糖治疗,联合组同时给予门冬胰岛素治疗,持续治疗3个月后,比较两组干预前后空腹血糖(FPG)、餐后2h血糖(2hPG)、糖化血红蛋白(HbA1c)、胱抑素C(Cys-C)、高同型半胱氨酸(Hcy)、N-乙酰-β-D-葡萄糖苷酶(NAG)、尿微量白蛋白(mALB)、妊娠并发症及分娩情况。结果干预后,两组FPG、2hPG、HbA1c水平均低于干预前,且联合组低于对照组,差异有统计学意义(P<0.05)。干预后,两组Cys-C、Hcy、NAG、mALB水平均低于干预前,且联合组低于对照组,差异有统计学意义(P<0.05)。两组羊水过多、低血糖及剖宫产发生率比较,差异无统计学意义(P>0.05)。联合组巨大儿发生率低于对照组(P<0.05);两组新生儿黄疸、呼吸窘迫、新生儿低血糖发生率比较,差异均无统计学意义(P>0.05)。结论二甲双胍联合门冬胰岛素治疗GDM具有更好的控糖效果,同时对肾功能具有一定的保护作用,可以有效降低巨大儿的发生率。

Objective To investigate the effect of Insulin Aspart Injection in the treatment of patients with gestational diabetes mellitus(GDM).Methods A total of 120 GDM patients admitted to Obstetrics and Gynecology Department of Huai’an First Hospital Affiliated to Nanjing Medical University from February 2016 to October 2018 were selected as research objects,and they were divided into combined group and control group of 60 cases by using a random number table.Both groups were given Metformin for glucose control,and combined group was given Insulin Aspart.After three months of continuous treatment,fasting blood glucose(FPG),two-hour postprandial blood glucose(2hPG),glycosylated hemoglobin(HbA1c),cystatin C(Cys-C),homocysteine(Hcy),N-acetyl-β-D-glucosidase(NAG),urinary microalbumin(mALB),pregnancy complications and delivery were compared between two groups before and after intervention.Results After intervention,the levels of FPG,2hPG and HbA1c in two groups were lower than those before intervention,and those in combined group were lower than those in control group(P<0.05).After intervention,Cys-C,Hcy,NAG and mALB levels in two groups were lower than those before intervention,and those in combined group were lower than those in control group(P<0.05).There were no significant differences in the incidence rates of polyhydramnios,hypoglycemia and cesarean section between two groups(P>0.05).The incidence rate of macrosomia in combined group was lower than that in control group(P<0.05).There were no significant differences in the incidence rates of neonatal jaundice,respiratory distress and neonatal hypoglycemia between two groups(P>0.05).Conclusion Metformin combined with Insulin Aspart in the treatment of GDM has a better sugar control effect,and at the same time has a certain protective effect on renal function,which can effectively reduce the incidence of huge children.