门冬胰岛素对妊娠期糖尿病孕妇血糖控制情况血清骨钙素水平及母婴不良结局的影响

Effect of insulin aspart on blood glucose control,serum osteocalcin level,and adverse maternal and infantile outcomes

目的分析门冬胰岛素对妊娠期糖尿病孕妇血糖控制情况、血清骨钙素水平及母婴不良结局的影响。方法选取2017年6月—2019年3月首都医科大学宣武医院收治的116例妊娠期糖尿病孕妇,按随机数字表法分为观察组(门冬胰岛素)与对照组(生物合成人胰岛素)各58例,比较两组孕妇血糖控制情况、血清骨钙素水平、母婴不良结局和不良反应发生情况。结果观察组血糖达标时间短于对照组,差异有统计学意义(P<0.05)。经过治疗两组餐前血糖、餐后2 h血糖及糖化血红蛋白均较治疗前降低,且观察组餐后2h血糖和糖化血红蛋白低于对照组,差异有统计学意义(P<0.05)。治疗后两组孕妇血清总骨钙素(tOC)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)。治疗后两组孕妇血清羧化不全骨钙素(ucOC)水平无明显改善,组间比较差异无统计学意义(P>0.05)。母婴不良结局总发生率比较差异无统计学意义(P>0.05)。治疗期间,观察组5例孕妇发生餐前低血糖,对照组8例孕妇发生餐前低血糖,不良反应发生率比较差异无统计学意义(P>0.05)。结论门冬胰岛素可有效改善妊娠期糖尿病孕妇血糖和血清骨钙素水平,避免母婴不良结局的发生。

Objective To analyze the effect of insulin aspart on blood glucose control,serum osteocalcin level,and adverse maternal and infantile outcomes.Methods From June 2017 to March 2019,116 pregnant women with gestational diabetes mellitus treated in Xuanwu Hospital of Capital Medical University were selected and divided into observation group(insulin aspart)and control group(human biosynthetic insulin),58 cases in each group.Blood glucose control,serum osteocalcin levels,adverse maternal and infantile outcomes,and adverse reactions in the two groups were compared.Results The time of reaching the expected level of blood glucose in observation group was statistically significantly shorter than that in control group(P<0.05).After treatment,the levels of blood glucose before meal,postprandial 2-hour blood glucose,and glycosylated hemoglobin in the two groups were lower than those before treatment,the levels of postprandial 2-hour blood glucose and glycosylated hemoglobin in observation group were lower than those in control group,there were statistically significant differences(P<0.05).After treatment,the levels of serum total osteocalcin in the two groups decreased,the level of serum total osteocalcin in observation group was lower than that in control group,there were statistically significant differences(P<0.05).After treatment,the levels of serum undercarboxylated osteocalcin(ucOC)in the two groups were not improved,there was no statistically significant difference(P>0.05).There was no statistically significant difference in the total incidence rate of adverse maternal and infantile outcomes between the two groups(P>0.05).During treatment,5 pregnant women in observation group and 8 pregnant women in control group were found with hypoglycemia before meals,there was no statistically significant difference in the incidence rate of adverse reactions(P>0.05).Conclusion Insulin aspart can effectively improve blood glucose and serum osteocalcin levels of pregnant women with gestational diabetes mellitus,avoid the occurrence of adverse maternal and infantile outcomes.