地特胰岛素联合门冬胰岛素对妊娠合并糖尿病患者的疗效及分娩结局的影响

Effects of insulin detemir combined with insulin aspart on the efficacy and delivery outcome of pregnant women with diabetes mellitus

目的探讨地特胰岛素联合门冬胰岛素治疗妊娠合并糖尿病患者的疗效,并观察患者的妊娠结局,为临床用药提供参考。方法收集2014年1月—2016年6月收治的102例妊娠合并糖尿病的患者作为研究对象,随机分为对照组和观察组,每组51例。其中,对照组采用精蛋白生物合成人胰岛素联合门冬胰岛素治疗,观察组采用地特胰岛素联合门冬胰岛素治疗,对比两组患者的血糖情况、血糖达标时间、低血糖发生率、分娩结局。结果两组治疗1周后,两组患者的空腹血糖(FPG)和餐后2h血糖(2hPG)、胰岛素用量比较差异均无统计学意义(P>0.05);观察组2hPG和注射次数均低于对照组(P<0.05),观察组的血糖达标时间短于对照组(P<0.05);两组产妇的分娩孕周、剖宫产、妊娠高血压发生率比较,差异无统计学意义(P>0.05),新生儿发生巨大儿、低血糖、高胆红素血症情况比较差异无统计学意义(P>0.05)。结论采用地特胰岛素联合门冬胰岛素治疗妊娠合并糖尿病患者能有效的控制血糖,降低了低血糖发生率,不良分娩结局较少。

Objective To observe the efficacy of insulin detemir combined with insulin aspart in the treatment of pregnant women with diabetes mellitus and to observe the outcome of the pregnancy.Methods Totally 102 cases of pregnant women with diabetes mellitus were collected from January 2014 to June 2016 and were randomly divided into control group(n=51) and observation group. Control group received the treatment of protamine biosynthetic human insulin combined with insulin aspart.Observation group were treated with insulin detemir combined with insulin aspart. The blood glucose level, standard time, incidence of hypoglycemia and delivery outcome were compared between the two groups. Results There was no significant difference in the levels of FPG and insulin dosage between the two groups after one week(all P>0.05). Compare with the control group, there were lower 2 hPG level and fewer times of injection in the observation group(all P<0.05). There were no significant differences in childbirth week, the rates of uterine-incision delivery and hypertension of pregnancy, and the rates of giant baby, hypoglycemia, hyperbilirubinemia in new born children between the two groups(all P>0.05). Conclusion Insulin detemir combined with insulin aspart therapy can help to control glouse level, reduce hypoglycemia incidence, improve the adverse pregnant outcome in pregnant women with diabetes mellitus.