益生菌辅助应用对妊娠期糖尿病患者血糖控制和Th细胞因子的影响

Effect of probiotics as supplementary therapy on blood glucose control and Th cytokines in patients with gestational diabetes mellitus

目的探讨益生菌辅助应用对妊娠期糖尿病(GDM)患者血糖控制和Th细胞因子的影响。方法选取2021年4月—2022年4月温州医科大学附属第二医院收治的80例GDM患者,按照随机数字表法分为对照组(40例,常规治疗)和观察组(40例,益生菌联合常规治疗)。对比两组患者治疗效果,血糖、血脂控制情况,Th细胞因子水平,母婴结局。结果观察组总有效率为97.50%,高于对照组的85.00%(χ^(2)=3.914,P<0.05)。治疗后,观察组患者空腹血糖(FBG)、餐后2 h血糖(2 h PG)、糖化血红蛋白(HbA1c)、空腹胰岛素(FINS)及稳态模型胰岛素抵抗指数(HOMA-IR)均低于对照组[观察组:(5.28±0.57)mmol/L、(6.49±0.71)mmol/L、(6.30±0.69)%、(17.26±1.96)mU/L、(4.05±0.54);对照组:(5.76±0.62)mmol/L、(7.29±0.83)mmol/L、(6.98±0.74)%、(18.98±2.22)mU/L、(4.86±0.56)],胰岛β细胞分泌指数(HOMA-β)高于对照组[观察组:(193.93±20.69);对照组:(167.96±17.74)],差异均有统计学意义(均P<0.05)。治疗后,观察组患者总胆固醇(TC)、三酰甘油(TG)及低密度脂蛋白(LDL)均低于对照组,高密度脂蛋白(HDL)均高于对照组(均P<0.05)。治疗后,观察组患者白细胞介素-2(IL-2)、干扰素-γ(IFN-γ)及肿瘤坏死因子-α(TNF-α)均低于对照组,白细胞介素-4(IL-4)、白细胞介素-10(IL-10)均高于对照组(均P<0.05)。观察组孕妇早产、剖宫产、羊水过多、产后感染、妊娠期高血压疾病、产后出血、低体质量儿、巨大儿、高胆红素血症及新生儿低血糖发生率均低于对照组(均P<0.05)。结论益生菌辅助治疗GDM患者可取得较好效果,可较好地控制血糖、血脂水平,改善Th细胞因子水平,改善母婴结局。

Objective To explore the effect of probiotics as supplementary therapy on blood glucose control and Th cytokines in patients with gestational diabetes mellitus(GDM).Methods Eighty pregnant women with GDM treated in the Second Affiliated Hospital of Wenzhou Medical University from April 2021 to April 2022 were selected and divided into control group(40 cases,routine treatment)and observation group(40 cases,probiotics combined with routine treatment)according to random number table.The therapeutic effects,blood glucose and blood lipid control,levels of Th cytokines,and maternal and infantile outcomes in the two groups were compared.Results The total effective rate in observation group(97.50%)was higher than that in control group(85.00%),there was statistically significant difference(χ^(2)=3.914,P<0.05).After treatment,fasting blood-glucose(FBG),2-hour postprandial blood glucose(2 h PG),glycosylated hemoglobin(HbA1c),fasting insulin(FINS),and homeostasis model assessment of insulin resistance(HOMA-IR)in observation group were lower than those in control group[observation group:(5.28±0.57)mmol/L,(6.49±0.71)mmol/L,(6.30±0.69)%,(17.26±1.96)mU/L,(4.05±0.54);control group:(5.76±0.62)mmol/L,(7.29±0.83)mmol/L,(6.98±0.74)%,(18.98±2.22)mU/L,(4.86±0.56)],homeostasis model assessment-β(HOMA-β)in observation group was higher than that in control group[observation group:(193.93±20.69);control group:(167.96±17.74)],there were statistically significant differences(P<0.05).After treatment,the levels of total cholesterol(TC),triglyceride(TG),and low-density lipoprotein(LDL)in observation group were lower than those in control group,the level of high-density lipoprotein(HDL)in observation group was higher than that in control group,there were statistically significant differences(P<0.05).After treatment,the levels of interleukin-2(IL-2),interferon-γ(IFN-γ),and tumor necrosis factor-α(TNF-α)in observation group were lower than those in control group,the levels of interleukin-4(IL-4)and interleukin-10(IL-10)in observation group were higher than those in control group,there were statistically significant differences(P<0.05).The incidence rates of premature delivery,cesarean section,polyhydramnios,postpartum infection,hypertensive disorder complicating pregnancy,postpartum hemorrhage,low body weight infants,macrosomia,hyperbilirubinemia,and neonatal hypoglycemia in observation group were statistically significantly lower than those in control group(P<0.05).Conclusion Probiotic as supplementary therapy for GDM patients can achieve good results,better control blood glucose and blood lipid levels,improve the levels of Th cytokines,and improve maternal and infantile outcomes.