生物合成人胰岛素与门冬胰岛素用于妊娠期糖尿病治疗的效果比较

Comparison of the effect of human insulin biosynthesis and insulin aspart in the treatment of gestational diabetes mellitus

目的比较生物合成人胰岛素与门冬胰岛素用于妊娠期糖尿病治疗的效果。方法选取2018年3月-2019年10月石门县人民医院收治的妊娠期糖尿病患者80例,采用随机数字表法分为A组和B组,每组40例。A组采用中效胰岛素联合生物合成人胰岛素治疗,B组采用中效胰岛素联合门冬胰岛素治疗,比较2组治疗前后空腹血糖、餐后2 h血糖及糖化血红蛋白水平、低血糖发生情况及随访妊娠结局。结果治疗3 d后,2组空腹血糖、餐后2 h血糖及糖化血红蛋白水平均较治疗前改善,且B组改善程度好于A组(P均<0.01)。B组血糖达标时间为(3.28±1.30)d,短于A组的(4.73±1.17)d(t=5.243,P=0.001)。B组低血糖发生率为2.50%,低于A组的20.00%(χ^(2)=6.135,P=0.013)。2组自然分娩与剖宫产例数占比无差异(P>0.05)。B组不良妊娠结局总发生率为5.00%,低于A组的35.00%(χ^(2)=11.250,P=0.001)。结论应用门冬胰岛素可显著提高妊娠期糖尿病患者的治疗效果,保证患者血糖的稳定,改善患者的妊娠结局,值得临床进一步探究与推广应用。

Objective To compare the effect of biosynthetic human insulin and insulin aspart in the treatment of gestational diabetes mellitus.Methods Eighty patients with gestational diabetes mellitus admitted to Shimen people's Hospital from March 2018 to October 2019 were selected and randomly divided into group A and group B with 40 cases in each group.Group A was treated with medium effect insulin combined with biosynthetic human insulin,and group B was treated with medium effect insulin combined with insulin aspart.Fasting blood glucose,2 h postprandial blood glucose,glycosylated hemoglobin,hypoglycemia and pregnancy outcomes were compared between the two groups before and after treatment.Results After 3 days of treatment,fasting blood glucose,2 h postprandial blood glucose and glycosylated hemoglobin in two groups were improved,and the improvement degree of group B was better than that of group A(all P<0.01).The time of blood glucose reaching the standard in group B was(3.28±1.30)d,which was shorter than that in group A(4.73±1.17)d(t=5.243,P=0.001).The incidence of hypoglycemia in group B was 2.50%,lower than that in group A(20.00%)(χ^(2)=6.135,P=0.013).There was no difference between the two groups in the number of cases of natural delivery and cesarean section.The total incidence of adverse pregnancy outcomes in group B was 5.00%,which was lower than 35.00%in group A(χ^(2)=11.250,P=0.001).Conclusion The application of insulin aspart can significantly improve the treatment effect of gestational diabetes mellitus patients,ensure the stability of blood glucose and improve the pregnancy outcome of patients,which is worthy of further clinical exploration and application.