妊娠期糖尿病孕妇不同时期加用胰岛素治疗对妊娠结局的影响

Effect of insulin therapy on pregnancy outcome in pregnant women with gestational diabetes mellitus at different stages

目的分析妊娠期糖尿病孕妇不同时期加用胰岛素治疗对妊娠结局的影响。方法60例妊娠期糖尿病孕妇为研究对象,按照加用胰岛素治疗的时期不同分为对照组和观察组,各30例。对照组孕妇在妊娠32周后给予胰岛素治疗,观察组孕妇在妊娠32周前给予胰岛素治疗。比较两组孕妇治疗前后的血糖指标[空腹血糖(FBG)、餐后2 h血糖(2 h PG)、空腹胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)]、血脂指标[甘油三酯(TG)、总胆固醇(TC)、游离脂肪酸(FFA)]、糖代谢指标[糖化血红蛋白(HbA1c)]、血清氧化应激指标[活性氧(ROS)、过氧化氢酶(CAT)、谷胱甘肽过氧化物酶(GSHPx)]水平及不良妊娠结局发生情况。结果治疗后,观察组孕妇的FBG、2 h PG、FINS、HOMA-IR水平均显著低于对照组,差异具有统计学意义(P<0.05)。治疗后,观察组孕妇的TG、TC、FFA、HbA1c水平均显著低于对照组,差异具有统计学意义(P<0.05)。观察组不良妊娠结局发生率10.00%低于对照组的33.33%,差异具有统计学意义(P<0.05)。治疗后,观察组孕妇的ROS(199.76±24.78)U/ml显著低于对照组的(289.78±45.89)U/ml,CAT(478.78±54.67)nmol/L、GSH-Px(49.89±5.76)U/ml均显著高于对照组的(386.78±36.78)nmol/L、(42.89±4.78)U/ml,差异具有统计学意义(P<0.05)。结论妊娠期糖尿病孕妇在妊娠32周前给予胰岛素治疗可以有效控制血糖水平,调节糖代谢指标,降低不良妊娠结局发生率,改善氧化应激指标水平。

Objective To analyze the effect of insulin therapy on pregnancy outcome in pregnant women with gestational diabetes mellitus at different stages.Methods A total of 60 pregnant women with gestational diabetes mellitus were divided into control group and observation group according to different periods of insulin treatment.The control group was treated with insulin therapy after 32 weeks of pregnancy,and the observation group was treated with insulin therapy before 32 weeks of pregnancy.The blood glucose[fasting blood glucose(FBG),2 h postprandial glucose(2 h PG),fasting insulin(FINS),homeostasis model assessment-insulin resistance(HOMA-IR)],blood lipid indexes[triglycerides(TG),total cholesterol(TC),free fatty acids(FFA)],glucose metabolism indexes[glycosylated hemoglobin(HbA1 c)],serum oxidative stress indexes[reactive oxygen species(ROS),catalase(CAT),glutathione peroxidase(GSH-Px)]before and after treatment,and occurrence of adverse pregnancy outcomes were compared between the two groups.Results After treatment,the levels of FBG,2 h PG,FINS and HOMA-IR of the observation group were significantly lower than those of the control group,and the difference was statistically significant(P<0.05).After treatment,the levels of TG,TC,FFA,HbA1 c of the observation group were significantly lower than those of the control group,and the difference was statistically significant(P<0.05).The incidence of adverse pregnancy outcomes 10.00%of the observation group was lower than 33.33%of the control group,and the difference was statistically significant(P<0.05).After treatment,the ROS(199.76±24.78)U/ml of the observation group was significantly lower than(289.78±45.89)U/ml of the control group,and CAT(478.78±54.67)nmol/L and GSH-Px(49.89±5.76)U/ml were significantly higher than(386.78±36.78)nmol/L and(42.89±4.78)U/ml of the control group.All the difference was statistically significant(P<0.05).Conclusion Insulin therapy for pregnant women with gestational diabetes mellitus before the 32 weeks of pregnancy can effectively control blood glucose level,regulate glucose metabolism index,reduce the incidence of adverse pregnancy outcomes and improve oxidative stress level.