胰岛素联合低分子肝素对妊娠期糖尿病患者血糖水平及炎症因子的影响

Effect of Insulin Combined with Low Molecular Weight Heparin on Blood Glucose Level and Inflammatory Factors in Patients with Gestational Diabetes Mellitus

目的分析胰岛素联合低分子肝素对妊娠期糖尿病患者血糖水平及炎症因子的影响。方法回顾性选取2023年1月—2024年2月泉州市第一医院收治的130例妊娠期糖尿病患者的临床资料,根据不同的治疗方式分为两组,各65例。两组均行运动及饮食指导,对照组行胰岛素治疗,研究组在对照组基础上联合低分子肝素治疗。于治疗前及分娩前1周,对比两组血糖(空腹血糖、餐后2 h血糖及糖化血红蛋白)水平、炎症因子(白细胞介素-13、白细胞介素-6、超敏C反应蛋白)水平、胰岛功能(空腹胰岛素、胰岛β功能指数、胰岛素抵抗指数)、并发症(酮症酸中毒、妊娠高血压、低血糖、妊娠期羊水过多)发生情况。结果分娩前1周,研究组糖化血红蛋白水平为(6.26±0.71)%,空腹血糖水平为(7.26±0.85)mmol/L,餐后2 h血糖水平为(8.25±1.26)mmol/L,均低于对照组的(6.92±0.58)%、(7.92±1.24)mmol/L、(8.76±1.54)mmol/L,差异有统计学意义(t=5.804、3.539、2.066,P均<0.05)。分娩前1周,研究组炎症因子水平均低于对照组,差异有统计学意义(P均<0.05)。研究组胰岛功能优于对照组,差异有统计学意义(P均<0.05)。两组并发症发生率对比,差异无统计学意义(P>0.05)。结论胰岛素联合低分子肝素治疗妊娠期糖尿病能够降低血糖水平与炎症因子,改善胰岛素抵抗水平,并降低并发症发生风险。

Objective To analyze the effect of insulin combined with low molecular weight heparin on blood glucose level and inflammatory factors in patients with gestational diabetes mellitus.Methods The clinical data of 130 pa-tients with gestational diabetes mellitus admitted to Quanzhou First Hospital from January 2023 to February 2024 were retrospectively selected.According to the different treatment methods,they were divided into two groups,with 65 cases in each group.Both groups were given exercise and diet guidance.The control group was treated with insulin,and the study group was treated with low molecular weight heparin on the basis of the control group.Before treatment and 1 week before delivery,The levels of blood glucose(fasting blood glucose,2-hour postprandial blood glucose and glycated hemoglobin A1c),inflammatory factors(interleukin-13,interleukin-6,high-sensitivity C-reactive protein),islet function(fasting insulin,isletβfunction index,insulin resistance index),occurence of complications(ketoacido-sis,pregnancy-induced hypertension,hypoglycemia,polyhydramnios during pregnancy)were compared between the two groups.Results One week before delivery,the glycated hemoglobin A1c level of the study group was(6.26±0.71)%,the fasting blood glucose level was(7.26±0.85)mmol/L,and the 2-hour postprandial blood glucose level was(8.25±1.26)mmol/L,which were lower than(6.92±0.58)%,(7.92±1.24)mmol/L,(8.76±1.54)mmol/L of the control group,the differences were statistically significant(t=5.804,3.539,2.066,all P<0.05).One week before delivery,the levels of inflammatory factors in the study group were significantly lower than those in the control group,the differ-ences were statistically significant(all P<0.05).The islet function levels in the study group were better than those in the control group,the differences were statistically significant(all P<0.05).There was no significant difference in the incidence of complications between the two groups(P>0.05).Conclusion The treatment of insulin combined with low molecular weight heparin in gestational diabetes mellitus can reduce blood glucose levels and inflammatory factors,improve insulin resistance levels,and reduce the risk of complications.