胰岛素泵持续皮下注射治疗妊娠糖尿病患者的血糖控制效果及对患者氧化应激反应的影响

Efficacy of Continuous Subcutaneous Injection of Insulin Pump on Blood Sugar Control and Its Effects on Oxidative Stress Reaction in Patients with Gestational Diabetes Mellitus

目的探讨胰岛素泵持续注射(CSⅡ)治疗妊娠糖尿病(GDM)患者的血糖控制效果及对患者氧化应激反应的影响。方法 150例GDM患者随机分为观察组(n=75)与对照组(n=75),对照组患者接受多次胰岛素皮下注射(MSⅡ)治疗,观察组患者接受CSⅡ治疗,均持续2个疗程。比较两组患者的治疗效果及治疗前后血糖相关指标、氧化应激指标水平。结果观察组的治疗有效率为97.33%,高于对照组的88.0%(P<0.05)。两组治疗前外周血中空腹血糖(FBG)、餐后2 h血糖(2hPBG)、空腹胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)水平比较差异均无统计学意义(均P>0.05);治疗后观察组患者的FBG(6.82±0.83)mmol/L、2hFBG(8.07±0.89)mmol/L、FINS(10.94±1.78)μIU/ml、HOMA-IR(1.31±0.16),低于对照组的FBG(7.93±0.92)mmol/L、2hFBG(9.82±0.95)mmol/L、FINS(14.12±1.61)μIU/ml、HOMA-IR(1.79±0.25),差异均有统计学意义(均P<0.05)。两组治疗前血清中活性氧(ROS)、过氧化氢酶(CAT)、谷胱甘肽过氧化物酶(GSH-Px)水平比较差异均无统计学意义(均P>0.05);观察组治疗后血清中ROS(199.81±25.35)U/ml,低于对照组的ROS(289.37±34.24)U/ml,观察组的CAT(472.12±52.84)nmol/L、GSH-Px(49.62±5.62)U/ml,高于对照组的CAT(394.26±45.17)nmol/L、GSH-Px(42.17±5.38)U/ml,差异均有统计学意义(均P<0.05)。结论 CSⅡ可有效提升GDM患者的治疗效果,在优化血糖水平同时降低全身氧化应激程度。

Objective explore the efficacy of continuous subcutaneous insulin pump injection(CSII)on blood sugar control and its effects on oxidative stress reaction in patients with gestational diabetes mellitus(GDM).Methods A total of 150 GDM patients were randomly divided into observation group(n=75)and control group(n=75).Patients in the control group were treated with multiple subcutaneous insulin injection(MSII),while patients in the observation group were treated with CSII,and both lasted for 2 courses of treatment.Between the 2 groups,the efficacy,blood glucose related indicators,and levels of oxidative stress indices were compared before and after the treatment.Results The total effective rate in the observation group was 97.33%,which was higher than the control group’s 88.0%(P<0.05).There was no significant difference in peripheral blood fasting blood glucose(FBG),2 h postprandial blood glucose(2 hPBG),fasting insulin(FINS)and homeostasis model assessment of insulin resistance(HOMA-IR)between the 2 groups before the treatment(P>0.05).After the treatment,the observation group’s FBG(6.82±0.83)mmol/L,2 hFBG(8.07±0.89)mmol/L,FINS(10.94±1.78)μIU/m L,and HOMA-IR(1.31±0.16)were lower than the control group’s FBG(7.93±0.92)mmol/L,2 hFBG(9.82±0.95)mmol/L,FINS(14.12±1.61)μIU/mL and HOMA-IR(1.79±0.25),and the difference was statistically significant(P<0.05).There was no significant difference in serum reactive oxygen species(ROS),catalase(CAT)and glutathione peroxidase(GSH-Px)between the 2 groups before the treatment(P>0.05).After the treatment,the observation group’s serum ROS(199.81±25.35)U/mL was lower than the control group’s ROS(289.37±34.24)U/mL;the observation group’s CAT(472.12±52.84)nmol/L and GSH-Px(49.62±5.62)U/m L were higher than the control group’s CAT(394.26±45.17)nmol/L and GSH-Px(42.17±5.38)U/mL,and the difference was statistically significant(P<0.05).Conclusion CSII can effectively improve the therapeutic effect in patients with GDM,and reduce the degree of oxidative stress while optimizing the level of blood glucose.