早期胰岛素治疗对妊娠期糖尿病患者妊娠结局的影响评价研究

Evaluation of the Effect of Early Insulin Therapy on Pregnancy Outcome in Patients with Gestational Diabetes

目的研究早期胰岛素治疗对妊娠期糖尿病患者妊娠结局的影响,为指导未来临床用药干预提供支持。方法选取该院于2020年1月—2021年1月收治的74例妊娠期糖尿病患者为研究对象,对照组患者在孕晚期实施胰岛素治疗,研究组患者则在孕早期实施胰岛素治疗,记录两组患者的妊娠结局等资料并做统计学处理。结果研究组患者分娩前的空腹血糖与餐后2 h血糖分别为(5.29±0.39)、(7.98±0.42)mmol/L,低于对照组,差异有统计学意义(t=8.173、12.099,P<0.05)。研究组患者分娩前脂肪细胞因子趋化素(Chemerin)水平为(58.13±4.26)ng/mL,低于对照组的(67.92±4.30)ng/mL,差异有统计学意义(t=9.838,P<0.05)。研究组患者不良妊娠结局的发生率为21.62%,低于对照组的45.95%,差异有统计学意义(χ^(2)=3.866,P<0.05)。研究组新生儿不良结局的发生率为5.41%,低于对照组的27.03%,差异有统计学意义(χ^(2)=4.874,P<0.05)。结论在妊娠期糖尿病患者临床干预阶段,早期胰岛素治疗可以进一步改善妊娠结局,促进患者血糖水平改善,并且有助于降低新生儿不良结局的产生,具有合理性。

Objective To study the effect of early insulin therapy on pregnancy outcome in patients with gestational diabetes, and to provide support for guiding future clinical interventions. Methods 74 cases of gestational diabetes patients admitted to the hospital from January 2020 to January 2021 were selected as the research objects. Patients in the control group were treated with insulin in the third trimester, and patients in the study group were treated with insulin in the first trimester. The pregnancy outcome and other data of the two groups of patients were recorded and statistically processed.Results The fasting blood glucose before delivery and the 2 h postprandial blood glucose of the study group were(5.29 ±0.39)mmol/L and(7.98 ±0.42)mmol/L, respectively, which were lower than those of the control group, the difference was statistically significant(t=8.173, 12.099, P<0.001). The adipocytokine chemokines(Chemerin) of patients in the study group before delivery was(58.13 ±4.26)ng/mL, which was lower than the control group(67.92 ±4.30)ng/mL, the difference was statistically significant(t=9.838, P<0.05). After comparing the data of adverse pregnancy outcomes between the two groups of patients, the incidence of the study group was only 21.62%, which was lower than the 45.95% of the control group, and the difference was statistically significant(χ^(2)=3.866, P<0.05). The incidence of adverse neonatal outcomes in the study group was 5.41%, which was lower than 27.03% in the control group, the difference was statistically significant(χ^(2)=4.874, P<0.05).Conclusion In the clinical intervention stage of patients with gestational diabetes, early insulin therapy can further improve pregnancy outcome and promote the improvement of patients’ blood glucose levels. It also helps to reduce the occurrence of adverse neonatal outcomes, which is reasonable.