n-3多不饱和脂肪酸增补治疗对妊娠期糖尿病患者的影响

Effect of n-3 Polyunsaturated Fatty Acid Supplementatitreatment in Patients with Gestational Diabetes Mellitus

目的:探讨n-3多不饱和脂肪酸(n-3 PUFA)增补治疗对妊娠期糖尿病(gestational diabetes mellitus,GDM)患者的影响。方法:选取2018年3月-2020年9月在十堰市妇幼保健院接受治疗的80例GDM患者为研究对象,根据随机数字表法分为对照组与观察组,各40例,对照组进行常规饮食与运动治疗,观察组基于对照组另增补n-3 PUFA进行治疗,对比两组治疗前后空腹状态下血糖(FPG)、用餐2 h后血糖(2 h PPG)、空腹胰岛素(FINS)及糖化血红蛋白(HbA1c)、胰岛素抵抗指数(HOMA-IR)、胰岛素使用率、妊娠并发症及分娩结局、新生儿结局。结果:治疗前,两组FBG、2 h PPG、FINS、HbA1c及HOMA-IR对比差异均无统计学意义(P>0.05);治疗后,两组FBG、2 h PPG、FINS、HbA1c及HOMA-IR均明显降低,观察组FPG、2 h PPG、HbA1c、FINS、HOMA-IR明显低于对照组(P<0.05)。两组新生儿呼吸窘迫综合征、新生儿窒息发生率对比差异均无统计学意义(P>0.05);观察组胰岛素使用率、妊娠期高血压、巨大胎儿、早产、剖宫产、新生儿低血糖发生率均明显低于对照组(P<0.05)。结论:增补n-3 PUFA可有效缓解GDM患者糖尿病症状,控制胰岛素抵抗,改善母婴结局,可作为推荐的相关临床治疗方案。

Objective:To investigate the effect of n-3 polyunsaturated fatty acid(n-3 PUFA)supplementation treatment on patients with gestational diabetes mellitus(GDM).Method:Eighty patients with GDM who were treated in Shiyan Maternal and Child Health Hospital from March 2018 to September 2020 were selected as the research objects.According to the random number table method,they were divided into the control group and observation group,with 40 cases in each group.The control group received regular diet and exercise therapy,the observation group was supplemented with n-3 PUFA based on the control group,and fasting blood glucose(FPG),2 hours postprandial plasma glucose(2 h PPG),fasting insulin(FINS),glycosylated hemoglobin(HbA1c),insulin resistance index(HOMA-IR)before and after treatment,the insulin utilization rate pregnancy complications,delivery outcomes and neonatal outcomes were compared between the two groups.Result:Before treatment,there were no significant differences in FBG,2 h PPG,FINS,HbA1c,and HOMA-IR between the two groups(P>0.05).After treatment,the FBG,2 h PPG,FINS,HbA1c,and HOMA-IR were significantly reduced,and the FBG,2 h PPG,FINS,HbA1c,and HOMA-IR of the observation group were significantly lower than those in the control group(P<0.05).There were no significant differences in the incidence of neonatal respiratory distress syndrome and neonatal asphyxia between the two groups(P>0.05);the insulin utilization rate,the incidence of gestational hypertension,macrosomia,premature delivery,hysterectomy and neonatal hypoglycemia in observation group were significantly lower than those in control group(P<0.05).Conclusion:Supplementation of n-3 PUFA can effectively alleviate the symptoms of diabetes in GDM patients,control insulin resistance,and improve maternal and infant outcomes.It can be used as a recommended clinical treatment plan.