二甲双胍联合门冬胰岛素对妊娠期糖尿病患者血糖代谢、肾损伤及妊娠结局的影响

Effects of metformin combined with insulin aspartate on blood glucose metabolism, renal injury and pregnancy outcome of patients with gestational diabetes mellitus

目的探讨二甲双胍联合门冬胰岛素对妊娠期糖尿病患者血糖代谢、肾损伤及妊娠结局的影响。方法按照不同的治疗方式将60例妊娠期糖尿病患者分为对照组与观察组,各30例。对照组以门冬胰岛素治疗,观察组在对照组基础上联合二甲双胍治疗。比较两组的治疗效果。结果治疗后,观察组的血糖代谢指标[空腹血糖(FPG)、空腹胰岛素(FINS)、24 h平均血糖波动幅度(MAGE)、日间血糖平均绝对值(MODD)]、肾损伤指标[尿微量白蛋白(mAlb)及血清胱抑素C(CysC)、游离脂肪酸(FFA)、中性粒细胞明胶酶相关脂质运载蛋白(NGAL)]、炎症指标[白细胞介素-6(IL-6)、转化生长因子-β_(1)(TGF-β_(1))、脂蛋白相关性磷脂酶A2(Lp-PLA2)]水平均低于对照组(P<0.05)。观察组新生儿与产妇的不良妊娠结局总发生率低于对照组(P<0.05)。结论二甲双胍联合门冬胰岛素治疗妊娠期糖尿病可降低患者的血糖水平,减少肾损伤,优化妊娠结局。

Objective To investigate the effects of metformin combined with insulin aspartate on blood glucose metabolism,renal injury and pregnancy outcome of patients with gestational diabetes mellitus.Methods Sixty patients with gestational diabetes mellitus were divided into control group and observation group according to the different treatment methods,with 30 cases in each group.The control group was treated with insulin aspartate,and the observation group was treated with metformin on the basis of the control group.The therapeutic effects of the two groups were compared.Results After treatment,the levels of blood glucose metabolism indexes[fasting plasma glucose(FPG),fasting insulin(FINS),24 h mean amplitude of glycemic excursions(MAGE)and mean of daily differences(MODD)],renal injury indexes[urine microabuminuria(mAlb)and serum cystatin C(CysC),free fatty acid(FFA)and neutrophil gelatinase-associated lipocalin(NGAL)]and inflammatory indexes[interleukin-6(IL-6),transforming growth factor-β_(1)(TGF-β_(1))and lipoprotein associated phospholipase A2(Lp-PLA2)]in the observation group were lower than those in the control group(P<0.05).The total incidences of adverse pregnancy outcomes in newborns and parturients in the observation group was lower than that in the control group(P<0.05).Conclusion Metformin combined with insulin aspartate in the treatment of gestational diabetes mellitus can reduce the level of blood glucose of patients,reduce renal injury,and optimize pregnancy outcomes.