妊娠期糖尿病患者应用门冬胰岛素联合盐酸二甲双胍治疗对其血糖及Hcy、CysC水平的影响

The Effect of Insulin Aspart Combined with Metformin Hydrochloride Treatment on Blood Glucose,Hcy and CysC Levels in Patients with Gestational Diabetes

目的探讨妊娠期糖尿病患者应用门冬胰岛素联合盐酸二甲双胍治疗对其血糖及Hcy、CysC水平的影响。方法选取2018年5月—2021年3月来该院就诊的妊娠期糖尿病患者80例,按照随机数表法分为两组,各40例。对照组在常规治疗基础上注射门冬胰岛素,观察组在对照组的基础上口服盐酸二甲双胍。两组均治疗至分娩结束。比较治疗前后两组血糖相关指标,血清Hcy、CysC、TBIL、UA、尿mAlb水平,治疗后妊娠及围生儿结局。结果与治疗前比较,治疗后两组血清FPG、2 hPG、HbA1c、Hcy、UA、CysC及尿mAlb水平均降低,且观察组低于对照组,差异有统计学意义(P<0.05);而治疗后两组血清TBIL水平均升高,且观察组高于对照组,差异有统计学意义(P<0.05);治疗后两组羊水过多、胎膜早破、剖宫产、巨大儿、早产、胎儿窘迫及新生儿窒息发生情况经对比,差异无统计学意义(P>0.05)。结论盐酸二甲双胍联合门冬胰岛素能有效控制妊娠期糖尿病患者血糖水平,提高胰岛素敏感性,保护微血管循环,降低胰岛素抵抗,改善肾脏功能,且安全性良好。

Objective To investigate the effect of insulin aspart combined with metformin hydrochloride treatment on blood glucose,Hcy and CysC levels in patients with gestational diabetes.Methods Eighty patients with gestational diabetes who came to the hospital from May 2018 to March 2021 were selected and divided into two groups according to the random number table method,each with 40 cases.The control group was injected with insulin aspart on the basis of conventional treatment,and the observation group was taken orally with metformin hydrochloride on the basis of the control group.Both groups were treated until the end of delivery.The blood glucose related indexes,serum Hcy,CysC,TBIL,UA,and urine mAlb levels of the two groups before and after treatment were compared,and the pregnancy and perinatal outcomes after treatment were compared.Results Compared with before treatment,serum FPG,2 hPG,HbAlc,Hcy,UA,CysC and urine mAlb levels in the two groups decreased after treatment,and the observation group was lower than the control group,and the difference was statistically significant(P<0.05).After treatment,the serum TBIL levels of the two groups all increased,and the observation group was higher than the control group,and the difference was statistically significant(P<0.05).After treatment,there was no statistically significant difference in the occurrence of polyhydramnios,premature rupture of membranes,cesarean section,macrosomia,premature delivery,fetal distress and neonatal asphyxia between the two groups(P>0.05).Conclusion Metformin hydrochloride combined with insulin aspart can effectively control the blood glucose level of patients with gestational diabetes,improve insulin sensitivity,protect microvascular circulation,reduce insulin resistance,improve renal function,and have good safety.