门冬胰岛素在妊娠期糖尿病治疗中的应用效果及对妊娠结局的影响评价

Effect of Insulin Aspart in the Treatment of Gestational Diabetes Mellitus and Evaluation of Its Influence on Pregnancy Outcome

目的探讨门冬胰岛素治疗方案在妊娠期糖尿病患者中的应用效果及对妊娠结局的影响。方法选取2021年1月—2023年12月漳州市第三医院收治的80例妊娠期糖尿病患者为研究对象,按照不同的治疗方法分为两组,各40例。研究组采用门冬胰岛素治疗,对照组采用生物合成人胰岛素治疗。比较两组血糖指标(空腹血糖、餐后2 h血糖、糖化血红蛋白)、胰岛素抵抗指数、空腹胰岛素水平、血糖变异性指标(平均血糖波动幅度、最大血糖波动幅度、血糖变异系数)、妊娠结局(早产、胎膜早破、产后出血)及新生儿并发症(胎儿窘迫、新生儿窒息、低体重儿)发生率。结果研究组不良妊娠结局和新生儿不良结局发生率均低于对照组,差异有统计学意义(P均<0.05)。治疗后,研究组血糖指标水平低于对照组,差异有统计学意义(P均<0.05)。治疗后,研究组胰岛素抵抗指数、空腹胰岛素水平低于对照组,差异有统计学意义(P均<0.05)。治疗后,研究组血糖变异性指标均低于对照组,差异有统计学意义(P均<0.05)。结论妊娠期糖尿病患者的健康管理,应用门冬胰岛素治疗方案后,可以让血糖水平持续处于正常、平稳的状态,进而为安全、顺利分娩提供良好的保障。

Objective To explore the application effect of insulin aspart therapy in patients with gestational diabetes mellitus and its influence on pregnany outcome.Methods A total of 80 patients with gestational diabetes mellitus ad-mitted to Zhangzhou Third Hospital from January 2021 to December 2023 were selected as the research objects,and they were divided into two groups according to different treatment methods,with 40 cases in each group.The study group was treated with insulin aspart,and the control group was treated with biosynthetic human insulin.The blood glucose indexes(fasting plasma glucose,2-hour postprandial plasma glucose,glycated hemoglobin Alc),insulin resis-tance index,fasting insulin level,blood glucose variability index(mean blood glucose fluctuation range,maximum blood glucose fluctuation range,blood glucose variation coefficient),pregnancy outcome(premature delivery,prema-ture rupture of membranes,postpartum hemorrhage)and neonatal complications(fetal distress,neonatal asphyxia,low birth weight)were compared between the two groups.Results The incidence of adverse pregnancy outcomes and the incidence of neonatal adverse outcomes in the study group were lower than those in the control group,and the differ-ences were statistically significant(both P<0.05).After treatment,the levels of blood glucose indexes in the study group were lower than those in the control group,and the differences were statistically significant(all P<0.05).After treatment,the insulin resistance index and fasting insulin level in the study group were lower than those in the control group,and the differences were statistically significant(both P<0.05).After treatment,the blood glucose variability in-dexes of the study group were lower than those of the control group,and the differences were statistically significant(all P<0.05).Conclusion The health management of patients with gestational diabetes mellitus,after the application of insulin aspart treatment,can keep the blood glucose level in a normal and stable state,and then provide a good guarantee for safe and smooth delivery.