益生菌联合胰岛素泵治疗妊娠期糖尿病患者的效果观察

Observation on the effect of probiotics combined with insulin pump in treatment of patients with gestational diabetes mellitus

目的探讨益生菌联合胰岛素泵治疗妊娠期糖尿病(GDM)患者的效果。方法选取2021年3月—2022年3月丽水市人民医院收治的104例GDM患者,随机分为对照组和观察组,每组各52例。对照组给予胰岛素泵治疗,观察组在对照组基础上给予益生菌治疗。比较两组血糖[空腹血糖(FBG)、餐后2 h血糖(2 h PG)、糖化血红蛋白(HbA1c)]及血脂[三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(LDL-C)]水平、胰岛素抵抗和胰岛素水平[空腹胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)]、血清氧化相关物质[还原型谷胱甘肽(GSH)、超氧化物歧化酶(SOD)、活性氧类物质(ROS)活性]及母婴结局。结果治疗后,观察组FBG、2 h PG、HbA1c水平分别为(5.16±0.69)mmol/L、(6.29±1.33)mmol/L、(6.65±1.10)%,均明显低于对照组的(5.90±0.96)mmol/L、(7.30±1.62)mmol/L、(7.55±1.23)%,差异均有统计学意义(均P<0.05)。治疗后,观察组TG、TC、LDL-C水平分别为(1.58±0.35)mmol/L、(5.39±0.45)mmol/L、(3.22±0.25)mmol/L,均明显低于对照组的(1.94±0.52)mmol/L、(5.82±0.47)mmol/L、(3.72±0.31)mmol/L,差异均有统计学意义(均P<0.05),HDL-C水平为(1.21±0.27)mmol/L,明显高于对照组的(1.05±0.22)mmol/L,差异有统计学意义(P<0.05)。治疗后,观察组FINS、HOMA-IR水平分别为(16.10±3.42)mU/L、(3.69±1.02),均明显低于对照组的(19.63±3.65)mU/L、(5.14±1.36),差异均有统计学意义(均P<0.05)。治疗后,观察组GSH、SOD水平分别为(29.00±5.13)μmol/L、(20.64±3.78)U/L,均明显高于对照组的(25.42±4.36)μmol/L、(18.10±3.52)U/L,ROS水平为(617.58±31.28)U/ml,明显低于对照组的(642.21±50.05)U/ml,差异均有统计学意义(均P<0.05)。观察组母婴不良结局总发生率为7.69%,明显低于对照组的25.00%(χ^(2)=4.300,P<0.05)。结论益生菌联合胰岛素泵治疗可有效控制GDM患者的血糖和血脂水平,改善胰岛素抵抗和胰岛素水平,调节血清氧化相关物质,降低母婴不良结局发生率。

Objective To explore the effect of probiotics combined with insulin pump in treatment of patients with gestational diabetes mellitus(GDM).Methods A total of 104 patients with GDM treated in Lishui People's Hospital from March 2021 to March 2022 were randomly divided into control group and observation group,52 cases in each group.The patients in control group were treated with insulin pump,and the patients in observation group were treated with probiotics based on control group.Blood glucose[fasting blood-glucose(FBG),2-hour postprandial glucose(2 h PG),glycosylated hemoglobin(HbA1c)]and blood lipids[triacylglycerol(TG),total cho-lesterol(TC),low density lipoprotein cholesterin(LDL-C),high density lipoprotein cholesterol LDL-C],insulin resistance and insulin[fasting insulin(FINS),insulin resistance index(HOMA-IR)],serum oxidation-related substances[reduced glutathione(GSH),su-peroxide dismutase(SOD),reactive oxygen species(ROS)activity],and matemal and infantile outcomes in the two groups were com-pared.Results After treatment,the levels of FBG,2 h PG,and HbA1c in observation group were(5.16±0.69)mmol/L,(6.29±1.33)mmol/L,and(6.65±1.10)%,respectively,which were significantly lower than those in control group[(5.90±0.96)mmol/L,(7.30±1.62)mmol/L,and(7.55±1.23)%](P<0.05).After treatment,the levels of TG,TC,LDL-C in observation group were(1.58±0.35)mmol/L,(5.39±0.45)mmol/L,and(3.22±0.25)mmol/L,respectively,which were significantly lower than those in control group[(1.94±0.52)mmol/L,(5.82±0.47)mmol/L,(3.72±0.31)mmol/L](P<0.05),the level of HDL-C in observation group was(1.21±0.27)mmol/L,which was significantly higher than that in control group[(1.05±0.22)mmol/L](P<0.05).After treatment,the levels of FINS and HOMA-IR in observation group were(16.10±3.42)mU/L and(3.69±1.02),respectively,which were significantly lower than those in control group[(19.63±3.65)mU/L and(5.14±1.36)](P<0.05).After treatment,the levels of GSH and SOD in observation group were(29.00±5.13)μmol/L and(20.64±3.78)U/L,respectively,which were significantly higher than those in control group[(25.42±4.36)μmol/L,(18.10±3.52)U/L](P<0.05),ROS level in observation group was(617.58±31.28)U/ml,which was significantly lower than that in control group[(642.21±50.05)U/ml](P<0.05).The total incidence rate of adverse maternal and infantile outcomes in observation group was 7.69%,which was significantly lower than that in control group(25.00%)(χ^(2)=4.300,P<0.05).Conclusion Probiotics combined with insulin pump can effectively control blood glucose and blood lipid levels in GDM patients,which can improve insulin resistance and insulin levels,regulate serum oxidation-related substances,and re-duce the incidence rate of adverse maternal and infantile outcomes.