胰岛素结合格列本脲治疗妊娠期糖尿病对患者妊娠结局及Nesfatin-1、Irisin水平影响

Effect of glibenclamide combined with insulin for treating pregnant women with gestational diabetes mellitus on their pregnancy outcomes and the levels of their Nesfatin-1 and Irisin

目的:探索胰岛素结合格列本脲治疗妊娠期糖尿病(GDM)对患者妊娠结局及摄食抑制因子-1(Nesfatin-1)、鸢尾素(Irisin)水平的影响。方法:纳入2018年8月-2019年12月本院产科收治的95例妊娠期糖尿病患者,按照入院先后编号随机数表法分成观察组(n=48)和对照组(n=47)。两组患者餐前皮下注射胰岛素,观察组加用格列本脲片,均治疗3个月。对比患者糖代谢指标、Nesfatin-1和Irisin水平、妊娠结局及不良反应等。结果:治疗后,两组患者糖代谢指标均降低且观察组低于对照组,两组血清Nesfatin-1降低、Irisin水平提高且观察组变化幅度优于对照组(P<0.05);剖宫产、流产和早产发生率观察组低于对照组(P<0.05);治疗期间,两组患者均出现肝功能异常、皮疹、胃肠道反应和低血糖等事件,但两组间未见差异(P>0.05)。结论:格列本脲联合胰岛素应用治疗GDM疾病,可有效纠正患者糖代谢功能紊乱,降低妊娠不良结局发生率,提高血清Irisin水平,降低血清Nesfatin-1浓度,用药安全。

Objective:To explore the effect of glibenclamide combined with insulin for treating pregnant women with gestational diabetes mellitus(GDM)on their pregnancy outcomes and the levels of their Nesfatin-1 and Irisin.Methods:95 pregnant women with GDM were enrolled in this study and were randomly divided into observation group(n=48)and control group(n=47)according to the serial number of admissions for treatment from August 2018 to December 2019.The women in the control group were subcutaneously injected with insulin before meal for 3 months,while the women in the observation group were given glibenclamide tablets on the basis of the control group for 3 months.The levels of glucose metabolism indexes,Nesfatin-1,and Irisin,the adverse reactions rate,and the pregnancy outcomes of the women were compared between the two groups.Results:After treatment,the levels of glucose metabolism indexes of the women in the two groups had decreased significantly,and which of the women in the observation group were significantly lower than those of the women in the control group.The level of serum Nesfatin-1 of the women in the two groups had decreased significantly,but the Irisin level of the women in the two groups had increased significantly,and the changes range of which of the women in the observation group were significantly better than those of the women in the control group(P<0.05).The incidences of cesarean section,abortion,and premature delivery of the women in the observation group were significantly lower than those of the women in the control group(P<0.05).During treatment,there were adverse events of abnormal liver function,rash,gastrointestinal reactions,and hypoglycemia in both groups,but which no significant different between the two groups(P>0.05).Conclusion:Glibenclamide combined with insulin for treating the pregnant women with GDM can effectively correct their dysfunction of glucose metabolism,reduce the incidence of their adverse pregnancy outcomes,increase their serum Irisin level,and reduce their serum Nesfatin-1 level with good safety of medication.