叶酸联合维生素B_(12)对妊娠期糖尿病患者糖代谢及妊娠结局的影响

Effects of Folic Acid Combined with Vitamin B_(12) on Glucose Metabolism and Pregnancy Outcomes in Patients with Gestational Diabetes Mellitus

目的:探讨叶酸联合维生素B_(12)辅助治疗对妊娠期糖尿病患者糖代谢及妊娠结局的影响。方法:收集2018年8月—2021年10月在安徽省桐城市人民医院妇产科门诊定期产检及住院生产的80例患有妊娠期糖尿病的孕妇为研究对象。采用随机数字表法将80例孕妇随机分为对照组(常规治疗组)和观察组(叶酸和维生素B_(12)辅助治疗组)各40例。比较干预前后2组孕产妇糖代谢指标[空腹血糖(FBG)、空腹胰岛素(FINs)、糖化血红蛋白(HbA1C)、胰岛素抵抗指数(HOMA-IR)]和孕妇及胎儿妊娠结局的差异。结果:2组患者治疗后,血清FBG、FINs、HbA1C、HOMA-IR水平均下降,但观察组下降程度显著高于对照组(P<0.05)。且叶酸和维生素B_(12)辅助治疗可有效降低孕产妇和新生儿不良妊娠结局发生率(P<0.05)。结论:叶酸和维生素B_(12)辅助治疗可降低患者FBG、FINs、HbA1C、HOMA-IR水平,改善胰岛素抵抗,增加胰岛素敏感性,改善妊娠结局,值得在临床上推广应用。

Objective To investigate the effect of folic acid combined with vitamin B_(12) adjuvant therapy on glucose metabolism and pregnancy outcomes in patients with gestational diabetes mellitus.Method A total of 80 pregnant women with gestational diabetes mellitus who received regular obstetric examinations and in-hospital deliveries in the outpatient department of obstetrics and gynecology of Tongcheng People's Hospital,Anhui province from August 2018 to October 20221 were collected as research objects.Using random number table method,80 pregnant women were randomly divided into control group(conventional treatment group)and observation group(folic acid and vitamin B_(12) adjuvant treatment group)with 40 cases in each group.The differences in maternal glucose metabolism indexes[fasting blood glucose(FBG),fasting insulins(FINs),glycated hemoglobin(HbA1C)and insulin resistance index(HOMA-IR)]and pregnancy outcomes of pregnant women and fetuses were compared between the two groups before and after the intervention.Result After treatment,the levels of serum FBG,FINs,HbA1C and HOMA-IR in the two groups were decreased,but the degree of decrease in the observation group was significantly higher than that in the control group(P<0.05).And adjuvant treatment of folic acid and vitamin B_(12) can effectively reduce the incidence of adverse pregnancy outcomes of pregnant women and newborns(P<0.05).Conclusion Folic acid and vitamin B_(12) adjuvant therapy can reduce the levels of FBG,FINs,HbA1C and HOMA-IR,improve insulin resistance,increase insulin sensitivity,and improve pregnancy outcomes.It is worthy of clinical application.