摘要
目的研究妊娠期糖尿病孕妇在孕32周前加用胰岛素对妊娠结局的影响。方法将2017年1月至2018年1月于咸阳市杨凌示范区医院接受治疗的98例孕周<32周的妊娠期糖尿病孕妇分为试验组和对照组,每组49例。对照组进行饮食及运动疗法干预,并给予二甲双胍;试验组在对照组基础上皮下注射胰岛素。比较2组孕妇干预前与分娩前空腹血糖(FPG)、餐后2 h血糖(2 h PG)及糖化血红蛋白(HbA1c)水平,比较2组新生儿出生5 min后Apgar评分、并发症总发生率(包括巨大儿、低血糖及胎儿窘迫),并比较2组孕妇在干预期间不良事件发生率。结果干预前2组孕妇FPG、2 h PG、HbA1c水平比较,差异无统计学意义(P>0.05),而分娩前试验组孕妇FPG、2 h PG、HbA1c水平均较对照组显著降低,差异有统计学意义(P<0.05)。与对照组相比,试验组新生儿Apgar评分显著升高,产后新生儿并发症总发生率显著降低,差异均有统计学意义(P<0.05)。2组孕妇在干预期间不良事件发生率比较,差异无统计学意义(P>0.05)。结论孕32周前注射胰岛素可有效控制妊娠期糖尿病孕妇的血糖水平,一定程度改善孕妇妊娠结局,保证孕妇和胎儿的健康。
Objective To investigate the effect of insulin supplementation on pregnancy outcome in pregnant women with gestational diabetes mellitus before 32 weeks of gestation.Methods Totally 98 pregnant women(gestational age<32 weeks)with gestational diabetes mellitus who were treated in Yangling Demonstration Area Hospital from January 2017 to January 2018 were selected as the research objects,and they were divided into experimental group and control group,49 cases in each group.The control group was given diet and exercise therapy intervention,and metformin;the experimental group was subcutaneously injected with insulin on the basis of the control group.Fasting blood glucose(FPG),2 h postprandial blood glucose(2 h PG)and glycosylated hemoglobin(HbA1c)levels were compared between the two groups before intervention and before delivery were compared.The Apgar score 5 minutes after birth,the total incidence of complications(include macrosomia,hypoglycemia and fetal distress)were compared between the two groups.The incidence of adverse events during the intervention was compared between the two groups.Results There was no significant difference in FPG,2 h PG and HbA1c levels between the two groups before the intervention(P>0.05),but the levels of FPG,2 h PG and HbA1c in the experimental group before delivery were significantly lower than those in the control group(P<0.05).Compared with the control group,the Apgar score of the experimental group was significantly increased,and the total incidence of complications was significantly reduced(P<0.05).There was no significantly difference incidence of adverse events between the two groups(P>0.05).Conclusion Insulin injection before 32 weeks of gestation can effectively control the blood glucose level of pregnant women with gestational diabetes mellitus,improve the pregnancy outcome to a certain extent,and ensure the health of pregnant women and fetus.
作者
高建丽
刘芳
GAO Jianli;LIU Fang(Department of Obstetrics,Yangling Demonstration Area Hospital,Xianyang,Shaanxi 712100,China;Department of Obstetrics and Gynecology,Zhen′an County Hospital,Shangluo,Shaanxi 711500,China)
出处
《检验医学与临床》
CAS
2020年第21期3156-3158,共3页
Laboratory Medicine and Clinic
关键词
胰岛素
妊娠结局
空腹血糖
餐后2
h血糖
糖化血红蛋白
insulin
pregnancy outcome
fasting blood glucose
postprandial 2 h blood glucose
glycosylated hemoglobin
