格列苯脲联合胰岛素治疗妊娠期糖尿病患者的疗效及对糖化血红蛋白和妊娠结局的影响

Efficacy of glibenclamide combined with insulin in the treatment of gestational diabetes mellitus and its influence on glycosylated hemoglobin and pregnancy outcome

目的探究格列苯脲联合胰岛素治疗妊娠期糖尿病患者的疗效及对糖化血红蛋白和妊娠结局的影响。方法本探究研究对象为2020年12月~2021年12月于我院治疗的80例妊娠期糖尿病患者,数字随机法分为为观察组与对照组,前者采用格列苯脲联合胰岛素治疗,后者只采用胰岛素治疗。比较治疗3个月后血糖控制情况,并记录治疗期间胰岛素用量以及血糖达标时间,详细记录患者围产期各项妊娠并发症以及剖宫产的发生率并比较两组产妇的妊娠结局;结果观察组胰岛素用量显著低于对照组,有统计学意义(P<0.05);两组治疗前糖化血红蛋白(HbA1c)、空腹血糖(FBG)、餐后2小时血糖(2hPBG)无统计学差异(P>0.05),治疗后两组均显著降低,且组间比较差异有统计学意义(P<0.05);两组孕妇围产期妊娠期高血压(妊高症)、胎膜早破、羊水过多、产程延长、剖宫产发生率无差异(P>0.05);观察组新生儿低血糖症、早产发生率显著低于对照组(P<0.05)。结论格列苯脲联合胰岛素治疗妊娠期糖尿病相较于单独使用胰岛素治疗能够降低胰岛素日用量,血糖控制效果更优。

Objective To explore the efficacy of glibenclamide combined with insulin in the treatment of gestational diabetes mellitus and its influence on glycosylated hemoglobin and pregnancy outcome.Methods 80 patients with gestational diabetes treated in our hospital from December 2020 to December 2021 were randomly divided into observation group and control group.The former was treated with glibenclamide combined with insulin,while the latter was only treated with insulin.Results The amount of insulin in the observation group was significantly lower than that in the control group,with statistical significance(P<0.05);the amount of glycosylated hemoglobin(HbA1c)in the two groups before treatment was significantly lower than that in the control group,with statistical significance(P<0.05),fasting blood glucose(FBG),2 hours postprandial blood glucose(2hpbg)had no significant difference(P>0.05),after treatment,the two groups were significantly reduced,and the difference between the two groups was significant,with statistical significance(P<0.05);there was no significant difference in the incidence of perinatal pregnancy induced hypertension(PIH),premature rupture of membranes,polyhydramnios,prolonged labor,cesarean section between the two groups(P>0.05)The incidence of neonatal hypoglycemia and premature birth in the observation group was significantly lower than that in the control group(P<0.05).Conclusion compared with insulin alone,glibenclamide combined with insulin in the treatment of gestational diabetes can reduce the daily dosage of insulin,improve the effect of blood glucose control.