二甲双胍与门冬胰岛素联合控制妊娠期糖尿病的效果及对妊娠结局的影响研究

Effect of Metformin Combined with Insulin Aspart on Gestational Diabetes Mellitus and Its Influence on Pregnancy Outcome

目的探讨二甲双胍与门冬胰岛素联合控制妊娠期糖尿病(gestational diabetes mellitus,GDM)的效果及对妊娠结局的影响。方法选取2020年1月—2023年12月漳州市平和县医院妇产科收治的76例GDM患者为研究对象,按照治疗方法的不同分为两组,各38例。对照组常规服用盐酸二甲双胍片治疗,观察组在对照组基础上联合门冬胰岛素治疗。比较两组空腹血糖(fasting blood glucose,FBG)、餐后2 h血糖(2-hour postprandial blood glucose,2 hPBG)、糖化血红蛋白(glycated hemoglobin A1c,HbA1c)、血清同型半胱氨酸(homocystinuria,HCY)、胱抑素C(Cystatin,CysC)水平及母婴不良结局发生情况。结果治疗4周后,两组FBG、2 hPBG、HbA1c、HCY、CysC水平均低于治疗前,且观察组均低于对照组,差异有统计学意义(P均<0.05)。观察组产后出血、巨大儿发生率均低于对照组,差异有统计学意义(P均<0.05)。两组新生儿呼吸窘迫、低血糖、早产发生率比较,差异无统计学意义(P均>0.05)。结论二甲双胍与门冬胰岛素联合治疗可提高GDM患者的血糖控制效果,降低HCY、CysC水平,改善妊娠结局。

Objective To explore the effect of metformin combined with insulin aspart on the control of gestational diabetes mellitus(GDM)and its effect on pregnancy outcome.Methods A total of 76 patients with GDM admitted to the Department of Obstetrics and Gynecology of Zhangzhou Pinghe County Hospital from January 2020 to December 2023 were selected as the research objects,and they were divided into two groups according to different treatment methods,with 38 cases in each group.The control group was routinely treated with metformin hydrochloride tablets,and the observation group was treated with insulin aspart on the basis of the control group.The levels of fasting blood glucose(FBG),2-hour postprandial blood glucose(2 hPBG),glycated hemoglobin A1c(HbA1c),serum homocysteine(HCY),Cystatin C(CysC)and the occurrence of maternal and infant adverse outcomes were compared between the two groups.Results After 4 weeks of treatment,the levels of FBG,2 hPBG,HbA1c,HCY and CysC in the two groups were lower than those before treatment,and the levels in the observation group were lower than those in the control group,the differences were statistically significant(all P<0.05).The incidences of postpartum hemorrhage and macrosomia in the observation group were lower than those in the control group,and the differences were statistically significant(both P<0.05).There were no significant differences in the incidence of neonatal respiratory distress,hypoglycemia and premature delivery between the two groups(all P>0.05).Conclusion The combination of metformin and insulin aspart can improve the blood glucose control effect of GDM patients,reduce the levels of HCY and CysC,and improve the pregnancy outcome.