二甲双胍联合胰岛素治疗妊娠糖尿病对血糖、CysC、HCY水平及妊娠结局的影响

The Effect of Metformin Combined with Insulin in the Treatment of Gestational Diabetes on Blood Glucose,CysC,HCY Levels and Pregnancy Outcome

目的探究二甲双胍联合胰岛素治疗妊娠糖尿病对血糖、血清胱抑素C(CysC)、血清同型半胱氨酸(HCY)水平及妊娠结局的影响。方法选取本院140例妊娠糖尿病患者,按照随机数字表法将其分为研究组和对照组,各70例。对照组给予门冬胰岛素注射液治疗,研究组在对照组基础上联合二甲双胍治疗。对比两组糖化血红蛋白、空腹血糖、餐后2 h血糖情况、HCY、CysC及妊娠结局。结果治疗后,研究组糖化血红蛋白、空腹血糖及餐后2 h血糖水平均显著低于对照组(P<0.05);研究组CysC、HCY水平分别为(0.74±0.03)mg/L.(7.52±2.06)μmol/L,显著低于对照组的(0.96±0.11)mg/L、(11.02±2.37)μmol/L(P<0.05);研究组并发症发生率为5.71%显著低于对照组的17.14%(P<0.05);研究组剖宫产发生例数为6例,显著少于对照组19例,自然分娩63例,显著多于对照组44例(P<0.05);两组早产和引产发生情况对比,差异无统计学意义(P>0.05)。结论二甲双胍联合胰岛素治疗妊娠糖尿病能有效降低血糖水平,改善HCY、CysC水平,降低并发症发生率,改善妊娠结局。

Objective To explore the effects of metformin combined with insulin in the treatment of gestational diabetes on blood glucose,serum cystatin C(CysC),serum homocysteine(HCY)levels and pregnancy outcome.Methods A total of 140 patients with gestational diabetes in this hospital were selected and divided into a study group and a control group according to the random number table method,with 70 cases in each group.The control group was treated with insulin aspart injection,and the study group was treated with metformin on the basis of the control group.The clinical treatment status of the two groups was compared,and the glycosylated hemoglobin,fasting blood glucose,blood glucose 2 h after meal,HCX Cys C and pregnancy outcome were analyzed.Results After treatment,the indicators of glycosylated hemoglobin,fasting blood glucose and 2 h postprandial blood glucose of the study group were significantly lower than those of the control group(P<0.05);the levels of CysC and HCY in the study group were(0.74±0.03)mg/L and(7.52±2.06)μmol/L,respectively.Significantly better than the control group(0.96±0.11)mg/L,(11.02±2.37)μmol/L(P<0.05);the complication rate of the study group was 5.71%significantly lower than that of the control group 17.14%(P<0.05);there were 6 cases of cesarean section in the study group,which was significantly lower than 19 cases in the control group,63 cases of natural delivery,which was significantly higher than 44 cases in the control group(P<0.05);there was no significant difference in the incidence of preterm labor and induction of labor between the two groups(P>0.05).Conclusion The combination of metformin and insulin in the treatment of gestational diabetes can effectively reduce blood sugar levels,improve HCY and Cys C levels,reduce the incidence of complications,and improve pregnancy outcomes.