胰岛素联合二甲双胍对妊娠期糖尿病临床效果及妊娠结局分析

Analysis of Clinical Effects of Insulin Combined with Metformin on Gestational Diabetes and Pregnancy Outcome

目的观察妊娠期糖尿病应用胰岛素、二甲双胍联合治疗的效果及妊娠结局。方法采集该院妇产科2016年12月—2017年12月收治的90例GDM患者临床资料,按随机数字表法分两组,每组45例,对照组药物治疗采用门冬胰岛素,观察组在其基础口服药物二甲双胍,比较两组血糖水平、妊娠结局及不良反应。结果观察组治疗后FBG(7.51±1.22)mmol/L、2 hPG(9.21±2.16)mmol/L、HbA1c(6.22±2.10)%相较于对照组低,差异有统计学意义(t=4.636、2.777、5.744,P<0.05);观察组治疗后产妇妊娠并发症概率4.44%、新生儿并发症概率4.44%相较于对照组17.78%、22.22%均较低,差异有统计学意义(χ^(2)=4.050、6.154,P<0.05);两组不良反应概率差异无统计学意义(χ^(2)=0.000,P>0.05)。结论妊娠期糖尿病应用胰岛素、二甲双胍联合治疗的效果显著,能有效降低血糖水平,改善妊娠结局,无严重不良反应增加。

Objective To observe the effect of combined treatment of insulin and metformin on gestational diabetes and the outcome of pregnancy.Methods The clinical data of 90 patients with GDM admitted to the department of obstetrics and gynecology in the hospital from December 2016 to December 2017 were divided into two groups according to the random number table method,each with 45 cases.The control group was treated with insulin aspart,and the observation group based on its basic oral drug metformin,the blood glucose level,pregnancy outcome and adverse reactions of the two groups were compared.Results After treatment,in the observation group,FBG(7.51±1.22)mmol/L,2 hPG(9.21±2.16)mmol/L,and HbA1c(6.22±2.10)% were lower than those in the control group,the difference was statistically significant(t=4.636,2.777,5.744,P<0.05);after treatment,the pregnancy complications rate of the observation group was 4.44%,and the neonatal complications rate was 4.44%,compared with the control group 17.78% and 22.22% were lower,the difference was statistically significant(χ^(2)=4.050,6.154,P<0.05);adverse reactions in the two groups was not statistically significant(χ^(2)=0.000,P>0.05).Conclusion The combined treatment of insulin and metformin for gestational diabetes has a significant effect,which can effectively reduce blood glucose levels and improve pregnancy outcomes without increasing serious adverse reactions.