摘要
目的 探讨不同孕周给予胰岛素治疗妊娠期糖尿病(gestational diabetes mellitus,GDM)的临床效果。方法 选取滨州医学院附属医院在2020年1月—2022年12月收治的500例妊娠期糖尿病患者,对其临床资料进行回顾性分析。以不同孕周分为对照组(250例,孕32周后给予胰岛素治疗)与试验组(250例,在孕32周前给予胰岛素治疗),对两组不同时间的血糖水平、分娩结局等进行比较。结果 治疗前,两组血糖水平(空腹血糖及餐后2 h血糖)比较,差异无统计学意义(P>0.05);治疗后,分娩前1周血糖均得到改善,且试验组糖化血红蛋白[(5.59±1.23)%]、空腹血糖[(4.69±1.22)mmol/L]及餐后2 h血糖[(6.47±1.56)mmol/L]均明显低于对照组,差异有统计学意义(P <0.05)。治疗前,两组胰岛素抵抗指数(insulin resistance inde,HOMA-IR)、胰岛β细胞功能指数(islet beta cell function index,HOMA-IS)比较,差异无统计学意义(P> 0.05);治疗后,试验组HOMA-IR显著低于对照组,HOMA-IS显著高于对照组(P <0.05)。试验组不良妊娠结局发生率为8.80%,明显低于对照组的24.40%,差异有统计学意义(P <0.05)。结论 孕32周之前给予胰岛素治疗妊娠期糖尿病,效果肯定,可更好地控制血糖水平,改善胰岛素功能,同时减少不良妊娠结局的发生。
Objective To investigate the clinical effect of insulin therapy on gestational diabetes mellitus(GDM)at different gestational weeks.Methods The clinical data of 500 patients with gestational diabetes admitted to Binzhou Medical University Hospital from January 2020 to December 2022 were retrospectively analyzed.The patients were divided into two groups according to different gestational weeks.The control group(250 cases,insulin treatment after 32 weeks of pregnancy)and the experimental group(insulin treatment before 32 weeks of pregnancy)were compared in blood glucose levels and delivery outcomes at different times.Results At the initial diagnosis,there was no statistically significant difference in blood glucose levels(fasting blood glucose and 2-hour postprandial blood glucose)between the two groups(P>0.05).After intervention,blood glucose levels improved one week before delivery,and the experimental group showed significantly lower levels of glycosylated hemoglobin[(5.59±1.23)%],fasting blood glucose[(4.69±1.22)mmol/L],and 2-hour postprandial blood glucose[6.47±1.56)mmol/L]compared to the control group,with statistically significant differences(P<0.05).At initial diagnosis,two groups of insulin resistance index(HOMA-IR)and pancreatic isletsβThere was no statistically significant difference in the ISLET beta cell function index(HOMA-IS)(P>0.05).After intervention,HOMA-IR in the experimental group was significantly lower than that in the control group,while HOMA-IS was significantly higher than that in the control group(P<0.05).The incidence of adverse pregnancy outcomes in the experimental group was 8.80%,significantly lower than the control group's 24.40%,with a statistically significant difference(P<0.05).Conclusion Insulin treatment of GDM before 32 weeks of pregnancy is effective,which can better control blood glucose level,improve insulin function,and reduce the occurrence of adverse pregnancy outcomes,which is worthy of clinical reference and promotion.
作者
李宁
姜小燕
杨延冬
LI Ning;JIANG Xiaoyan;YANG Yandong(Department of Obstetrics and Gynecology,Binzhou Medical University Hospital,Binzhou Shandong 256603,China)
出处
《中国卫生标准管理》
2023年第21期42-45,共4页
China Health Standard Management
关键词
不同孕周
胰岛素
妊娠期糖尿病
血糖水平
不良妊娠结局
胰岛素抵抗
different gestational weeks
insulin
gestational diabetes mellitus
blood sugar levels
adverse pregnancy outcomes
insulin resistance
