盐酸二甲双胍联合门冬胰岛素治疗妊娠糖尿病的临床效果

Clinical Effect of Metformin Hydrochloride Combined with Insulin Aspart in the Treatment of Gestational Diabetes

目的研究妊娠期糖尿病行门冬胰岛素、盐酸二甲双胍联合治疗的效果。方法在课题开展期间(2019年5月—2020年5月)盲选88例妊娠期糖尿病者为观察对象,基础组的44例行门冬胰岛素控糖,综合组的44例行门冬胰岛素+盐酸二甲双胍控糖,对比疗效。结果综合组未经治疗前2 hPG水平维持在(12.81±1.63)mmol/L,FPG水平维持在(9.68±1.25)mmol/L,HbAlc水平维持在(9.59±1.46)%,和基础组差异无统计学意义(t=0.055、0.141、0.220,P=0.957、0.888、0.826)。综合组经控糖药物治疗后2 hPG水平维持在(9.87±0.64)mmol/L,FPG水平维持在(5.19±0.82)mmol/L,HbAlc水平维持在(6.11±0.70)%,数据和基础组之间差异有统计学意义(t=5.874、6.128、7.782,P<0.001)。综合组未经治疗前,Hcy水平维持在(14.91±1.62)μmol/L,CysC水平维持在(1.49±0.60)mg/L,数据与基础组间差异无统计学意义(t=0.056、0.167,P=0.955,0.868>0.05)。综合组经降糖药物治疗后,Hcy水平维持在(8.02±0.94)μmol/L,CysC水平维持在(0.73±0.09)mg/L,数据与基础组间差异有统计学意义(t=7.908、7.572,P<0.001)。综合组剖宫产率仅有34.09%(15例),自然分娩率高达65.91%(29例),不良分娩结局发生率为27.27%(12例),数据与基础组数据56.82%(25例)、43.18%(19例)、52.27%(23例),差异有统计学意义(χ2=4.583,P=0.032<0.05)。结论妊娠期糖尿病者行门冬胰岛素+盐酸二甲双胍治疗后控糖效果优异,分娩结局较好。

Objective To study the effect of combined treatment of insulin aspart and metformin hydrochloride on gestational diabetes.Methods During the project development period(May 2019-May 2020),88 patients with gestational diabetes were blindly selected as observation objects.44 patients in the basic group received insulin aspart for glucose control,and 44 patients in the comprehensive group received insulin aspart+metformin hydrochloride controls sugar and compares efficacy.Results Before treatment in the comprehensive group,the 2 hPG level was maintained at(12.81±1.63)mmol/L,the FPG level was maintained at(9.68±1.25)mmol/L,and the HbAlc level was maintained at(9.59±1.46)%,Compared the basic group was inconsistent with the normal distribution,the difference was not statistically significant(t=0.055,0.141,0.220,P=0.957,0.888,0.826).In the comprehensive group,the 2 hPG level was maintained at(9.87±0.64)mmol/L,the FPG level was maintained at(5.19±0.82)mmol/L,and the HbAlc level was maintained at(6.11±0.70)%after the treatment of glucose control drugs,the difference was statistically significant(t=5.874,6.128,7.782,P<0.001).Before treatment in the comprehensive group,the Hcy level was maintained at(14.91±1.62)μmol/L,and the CysC level was maintained at(1.49±0.60)mg/L.The difference was not statistically significant(t=0.056,0.167,P=0.955,0.868>0.05).After treatment with hypoglycemic drugs in the comprehensive group,the Hcy level was maintained at(8.02±0.94)μmol/L,and the CysC level was maintained at(0.73±0.09)mg/L.The difference was statistically significant(t=7.908,7.572,P<0.001).The cesarean section rate in the comprehensive group was only 34.09%(15 cases),the natural delivery rate was as high as 65.91%(29 cases),and the incidence of adverse delivery outcomes was 27.27%(12 cases).The data and basic group data were 56.82%(25 cases),43.18%(19 cases),52.27%(23 cases),the difference was statistically significant(χ2=4.583,P=0.032<0.05).Conclusion Insulin aspart+metformin hydrochloride treatment in patients with gestational diabetes mellitus has excellent glucose control effect and good delivery outcomes.