摘要
目的:探讨胰岛素泵持续强化治疗妊娠期糖尿病对新生儿脐带血胰岛素样生长因子-1(IGF-I)水平与出生体重的影响。方法:选择妊娠期糖尿病患者42例,其中胰岛素泵治疗组(CSII组)20例,胰岛素多次皮下注射(MSII)治疗组(MSII组)22例,妊娠期正常孕妇(对照组)24例。测定孕妇空腹血糖、餐后2 h血糖、糖化血红蛋白及其分娩的新生儿体重、脐带血胰岛素样生长因子-1水平。结果:CSII组与MSII组比较,孕妇空腹血糖、产后2 h血糖、糖化血红蛋白差异有统计学意义(P<0.001),与对照组比较差异无统计学意义(P>0.05)。CSII组与MSII组比较,新生儿出生体重及IGF-1水平分别为(3 228±343)g和(3 792±381)g;(57±21)μg/L和(82±26)μg/L,差异有统计学意义(P<0.001),与对照组比较差异无统计学意义(P>0.05)。脐带血IGF-1水平与新生儿出生体重之间呈正相关(Pearson相关系数:0.715,P<0.01)且有直线关系(R2=0.511,P<0.01)。结论:胰岛素泵持续强化治疗妊娠期糖尿病能更好地控制孕妇血糖,明显改善新生儿脐带血IGF-1水平与出生体重,临床应用效果优于传统的胰岛素多次皮下注射。
Objective ：To evaluate the effect of long- term intensified treatment by continuous subcutaneous insulin infusionin gestational diabetes mellitus on neonate cord blood insulin - like growth factor - 1 and neonate birth weight. Methods ： A total of 42 gestational diabetes mellitus were enrolled in this study and were divided into insulin pump （CSII） group and multiple subcutaneous insulin injection（MSII） group. 20 of the women were CSII group and the other were MSII group. 24 of normal gestational women were control group. To monitor glycosylated hemoglobin,the fasting and postprandial 2 h blood glucose lev- els. To evaluate the neonate cord blood insulin - like growth faeter - 1 level and neonate birth weight. Results ： Glycosylated he- moglobin, the fasting and postprandial 2 h blood glucose levels were both significantly lower in CSII group than those in MSII group（ P 〈 0.001 ）. There were no statistics difference between CSII group and control group （P 〉 0. 05 ）. There was a positive rectilinear correlation between neonatal birth weight and neonate cord blood IGF - 1 levels （ Pearson ＇ s correlation coefficient ： 0.715, P 〈 0. 01 ） and straight line relationship （ R2 = 0.511, P 〈 0.01 ）. Conclusion ： Long - term intensified insulin pump treatment on gestational diabetes mellitus can control hyperglycemia of pregnant woman preferably and ameliorate neonatal birth weight and neonate cord blood IGF - 1 levels. The elinical effect of long - term intensified pump treatment is better than traditional multiple subcutaneous insulin injection regimen.
出处
《临床医药实践》
2014年第4期251-254,共4页
Proceeding of Clinical Medicine
