门冬胰岛素联合地特胰岛素治疗妊娠期糖尿病患者疗效及对血清NRG4 HGF SAA水平胰岛细胞功能的影响

Efficacy of Insulin Aspart Combined with Insulin Detemir in the Treatment of Patients with GDM and the Effect on Serum NRG4,HGF and SAA Levels and Islet Cell Function

目的:探讨门冬胰岛素联合地特胰岛素治疗妊娠期糖尿病(GDM)患者疗效及对血清神经调节蛋白4(NRG4)、肝细胞生长因子(HGF)、淀粉样蛋白A(SAA)水平、胰岛细胞功能的影响。方法:选取2020年6月至2023年6月我院收治的113例GDM患者,采用简单随机法分为对照组(n=56)和观察组(n=57),对照组给予门冬胰岛素联合精蛋白生物合成人胰岛素治疗,观察组给予门冬胰岛素联合地特胰岛素治疗,比较两组胰岛素使用情况和血糖达标时间、血糖[空腹血糖(FBG)、餐后2h血糖(2hPBG)、糖化血红蛋白(HbA1c)]及血清NRG4、HGF、SAA水平和胰岛细胞功能[胰岛素抵抗指数(HOMA-IR)、β细胞分泌指数(HOMA-β)、空腹胰岛素(FINS)]、妊娠结局。结果:观察组胰岛素用量和注射次数少于对照组,血糖达标时间短于对照组(P<0.05)。观察组FBG、2hPBG、HbA1c治疗前后差值均高于对照组(P<0.05)。观察组血清NRG4、HGF、SAA水平治疗前后差值均高于对照组(P<0.05)。观察组HOMA-β、HOMA-IR、FINS治疗前后差值均高于对照组(P<0.05)。两组剖宫产、巨大儿、新生儿低血糖和胎儿呼吸窘迫发生率比较差异无统计学意义(P>0.05)。结论:门冬胰岛素联合地特胰岛素治疗GDM疗效显著,可控制血糖,缩短血糖达标时间,改善血清NRG4、HGF、SAA水平和胰岛细胞功能。

Objective:To investigate the efficacy of insulin aspart combined with insulin detemir in the treatment of GDM and the effect on serum neuregulin 4(NRG4),HGF,and amyloid A(SAA)levels and islet cell function.Methods:From June 2020 to June 2023,113 patients with GDM were selected and randomly divided into the control group(n=56)and the observation group(n=57).The control group was treated with insulin aspart combined with premixed protamine recombinant human insulin while the observation group was treated with insulin aspart combined with insulin detemir.The two groups were compared on insulin use,time to blood glucose reaching the standard,blood glucose indicators(FBG,2hPBG,and HbA1c),serum NRG4,HGF and SAA levels,islet cell function indicators[HOMA-IR,Homeostasis Model Assessment of beta-cell(HOMA-β)and fasting insulin(FINS)]and pregnancy outcomes.Results:The dosage of insulin and injection frequency in the observation group were lower than in the control group,and the time to blood glucose reaching the standard was shorter than that in the control group(P<0.05).The differences in FBG,2hPBG,HbA1c,serum NRG4,HGF and SAA levels,HOMA-β,HOMA-IR,and FINS before and after treatment in the observation group were greater than those in the control group(all P<0.05).There was no statistically significant difference in the incidence rates of cesarean section,fetal macrosomia,neonatal hypoglycemia,and fetal distress between the two groups(P>0.05).Conclusion:The combined treatment with insulin aspart and insulin detemir has a significant therapeutic effect on GDM,which can control blood glucose,shorten the time for blood glucose to reach the standard,and improve serum NRG4,HGF,and SAA levels as well as islet cell function.