孕中期口服双歧杆菌四联活菌辅助治疗妊娠期糖尿病的效果

Effect of oral bifidobacterium quadruple viable bacteria on pregnant diabetes

目的 探讨在孕中期口服双歧杆菌四联活菌对妊娠期糖尿病患者胰岛素抵抗以及妊娠结局的影响。方法 选取2020年7月至2022年2月温州医科大学附属第一医院营养科接收的妊娠期糖尿病患者140例,根据治疗方法将其分为2组。给予常规治疗措施的70例患者为对照组,口服双歧杆菌四联活菌胶囊进行辅助治疗的70例患者为观察组,8周为1个疗程。比较2组餐后2 h血糖(2 h PG)、空腹血糖(FBG)、胰岛素抵抗指数(HOMA-IR)、血脂水平[总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、载脂蛋白-B(Apo-B)、高密度脂蛋白(HDL-C)水平]以及不良妊娠结局。结果 观察组治疗后FBG(4.23±0.96)mmol/L、2 h PG水平(5.60±1.06)mmol/L以及HOMA-IR指数(6.20±1.53)、TC (4.97±0.48)mmol/L、LDL-C (2.26±0.21)mmol/L、ApoB水平(1.41±0.25)g/L均低于对照组[(5.04±1.02)mmol/L、(6.57±1.21)mmol/L、(7.34±1.60)、(5.28±0.56)mmol/L、(2.63±0.27)mmol/L、(1.57±0.28)g/L],HDL-C (2.03±0.28)mmol/L高于对照组(1.90±0.32)mmol/L (P<0.05);观察组不良妊娠结局发生率[早产(2.8%)、羊水过多(1.4%)、胎儿窘迫(1.4%)、妊娠期高血压(4.3%)、新生儿低血糖(4.3%)]较对照组更低[早产(15.7%)、羊水过多(8.6%)、胎儿窘迫(10.0%)、妊娠期高血压(17.1%)、新生儿低血糖(11.4%)](P<0.05)。结论 双歧杆菌四联活菌能够有效辅助妊娠期糖尿病患者减轻其胰岛素抵抗,改善患者血脂水平,减少不良妊娠结局的发生,值得临床推广应用。

Objective To investigate the effect of oral administration of Bifidobacterium tetrad viable bacteria on insulin resistance and pregnancy outcome in patients with gestational diabetes.Methods One hun-dred and forty patients with gestational diabetes received by First Affiliated Hospital of Wenzhou Medical Univer-sity from July 2020 to February 2022 were selected and divided into two groups according to different treatments.The control group consisted of 70 patients who received routine treatment measures,and the observation group consisted of 70 patients who received oral Bifidobacterium quadruple viable capsule as an adjuvant treatment.The treatment lasted for 8 weeks.Compare the 2-hour postprandial blood glucose(2 h PG),fasting blood glucose(FBG),insulin resistance index(HOMA-IR),blood lipid levels[total cholesterol(TC),low-density lipoprotein(LDL-C),apolipoprotein B(Apo-B),high-density lipoprotein(HDL-C)levels],and adverse pregnancy outcomes between the two groups.Results After treatment,the FBG(4.23±0.96),2 h PG(5.60±1.06)mmol/L,HOMA-IR index(6.20±1.53),TC(4.97±0.48)mmol/L,LDL-C(2.26±0.21)mmol/L,and ApoB(1.41±0.25)g/L in the observation group were significantly lower than those in the control group[(5.04±1.02)mmol/L,(6.57±1.21)mmol/L,7.34±1.60,(5.28±0.56)mmol/L,(2.63±0.27)mmol/L,(1.57±0.28)g/L],and HDL-C(2.03±0.28)mmol/L was higher than that in the con-trol group(1.90±0.32)mmol/L(P<0.05);The incidence of adverse pregnancy outcomes in the observation group[premature delivery(2.8%),polyhydramnios(1.4%),fetal distress(1.4%),gestational hypertension(4.3%),and neonatal hypoglycemia(4.3%)]was lower than that in the control group[premature delivery(15.7%),polyhydram-nios(8.6%),fetal distress(10.0%),gestational hypertension(17.1%),and neonatal hypoglycemia(11.4%)](P<0.05).Conclusion Bifidobacterium tetrad viable bacteria can effectively assist pregnant women with diabetes to reduce their insulin resistance,improve their blood lipid levels,and reduce the incidence of adverse pregnancy outcomes,which is worthy of clinical application.