妊娠期糖尿病治疗中运动疗法联合门冬胰岛素注射液对患者血糖指标及不良妊娠结局的影响

Effect of Exercise Therapy Combined with Menthol Insulin Injection on Patients’Glycemic Index and Adverse Pregnancy Outcome in the Treatment of Gestational Diabetes Mellitus

目的研究运动疗法与门冬胰岛素注射液联合用于治疗妊娠期糖尿病(gestational diabetes mellitus,GDM)的效果。方法选取2020年1月—2022年1月深圳市妇幼保健院收治的100例GDM患者为研究对象,随机分为研究组(50例)与对照组(50例)。对照组采用运动疗法联合二甲双胍片治疗,研究组采用运动疗法联合门冬胰岛素注射液治疗。比较两组治疗前后血糖指标[空腹血糖(FPG)、餐后2 h血糖(2 hPG)]水平与脐、肾动脉血流动力学指标[阻力指数(RI)、收缩期最大血流速度与舒张末期血流速度比值(S/D)]水平变化,并比较两组治疗后不良妊娠结局(胎儿宫内窘迫、巨大儿、畸形儿、新生儿低血糖)和并发症(继发感染、产后出血、酮症酸中毒、妊高症)发生情况。结果治疗前,两组血糖指标与脐、肾动脉血流动力学指标水平差异无统计学意义(P>0.05);治疗后,研究组血糖指标水平,脐、肾动脉血流动力学指标水平,不良妊娠结局发生率和并发症发生率低于对照组,差异有统计学意义(P<0.05)。结论GDM治疗中运动疗法联合门冬胰岛素注射液的疗效显著,可有效改善患者血糖水平与胎儿脐、肾动脉RI、S/D,降低不良妊娠结局发生率。

Objective To study the effect of exercise therapy combined with insulin aspart injection in the treatment of gestational diabetes(GDM).Methods 100 GDM patients admitted to Shenzhen Maternal and Child Health Hospital from January 2020 to January 2022 were selected as research objects,and randomly divided into study group(50cases)and control group(50 cases).The control group was treated with exercise therapy combined with metformin tablets,and the study group was treated with exercise therapy combined with aspart insulin injection.The changes of blood glucose indexes[fasting blood glucose(FPG),2 h postprandial blood glucose(2 hPG)]and umbilical and renal arterial hemodynamics indexes[resistance index(RI),ratio of maximum systolic blood velocity to end-diastolic blood velocity(S/D)]before and after treatment were compared between the two groups.Adverse pregnancy outcomes(intrauterine fetal distress,macrosomia,teratosis,neonatal hypoglycemia)and complications(secondary infection,postpartum hemorrhage,ketoacidosis,pregnancy-induced hypertension)were compared between the two groups after treatment.Results Before treatment,there was no statistically significant difference in the levels of blood glucose indexes and umbilical and renal artery hemodynamic indexes between the two groups(P>0.05).After treatment,the levels of glycemic indexes and umbilical and renal artery hemodynamic indexes,the incidence of adverse pregnancy outcomes,and the incidence of complications were lower in the study group than in the control group,and the differences were statistically significant(P<0.05).Conclusion The efficacy of exercise therapy combined with menthol insulin injection in the treatment of GDM is significant,which can effectively improve the patients’blood glucose levels and fetal umbilical and renal artery RI and S/D,and reduce the incidence of adverse pregnancy outcomes.