地特胰島素治療妊娠期糖尿病的療效及對母嬰結局的影響研究

王新英

[摘要] 目的 探討地特胰島素治療妊娠期糖尿病的療效及對母嬰結局的影響。 方法 選擇2017年1月～2018年1月在我院住院的妊娠期糖尿病產婦100例為研究對象，隨機分為觀察組與對照組，每組各50例。兩組均進行飲食控制及適當運動，每天三餐餐前使用門冬胰島素0.3 U/kg，對照組予優泌林0.1 U/kg，每天1次，于睡前注射，觀察組同時加用地特胰島素0.1 U/kg，每天1次，于睡前注射;兩組均連續治療8周。治療后比較兩組的血糖控制情況及母嬰結局。 結果 兩組患者治療后的空腹血糖、餐后2 h血糖及糖化血紅蛋白水平分別顯著低于治療前，且觀察組患者治療后的空腹血糖、餐后2 h血糖及糖化血紅蛋白水平顯著低于對照組，兩組血糖控制情況比較，差異有統計學意義（P<0.05）。觀察組患者治療后剖宮產、子癇前期、早產、胎膜早破、新生兒窒息、低血糖的發生率分別顯著低于對照組， 差異有統計學意義（P<0.05）。 結論 地特胰島素治療妊娠期糖尿病療效確切，顯著改善母嬰結局，值得臨床推廣和應用。

[關鍵詞] 妊娠期糖尿病;母嬰結局;空腹血糖;餐后2 h血糖;糖化血紅蛋白

[中圖分類號] R714.256? ? ? ? ? [文獻標識碼] B? ? ? ? ? [文章編號] 1673-9701（2019）04-0054-03

[Abstract] Objective To investigate the efficacy of insulin detemir in the treatment of gestational diabetes mellitus and its effect on maternal and fetal outcomes. Methods 100 puerperas with gestational diabetes mellitus admitted in our hospital from January 2017 to January 2018 were enrolled in the study. They were randomly divided into observation group and control group， with 50 cases in each group. Both groups were given diet control and appropriate exercise， and were given insulin aspart 0.3U/kg before three meals a day. The control group was given 0.1 U/kg of the eucalyptus before the bedtime， once a day. The observation group was added with the insulin detemir 0.1 U/kg， once a day， before bedtime. Both groups were continuously treated for 8 weeks. After treatment， the blood glucose control and maternal and fetal outcomes were compared between the two groups. Results The fasting blood glucose， postprandial 2 h blood glucose and glycosylated hemoglobin levels between the two groups after treatment were significantly lower than those before treatment. And the fasting blood glucose， postprandial 2 h blood glucose and glycosylated hemoglobin levels in the observation group were significantly lower than those in the control group. There was significant difference in the blood glucose control between the two groups（P<0.05）. The incidences of cesarean section， preeclampsia， premature delivery， premature rupture of membranes， neonatal asphyxia， and hypoglycemia were significantly lower in the observation group after treatment than those in the control group. The difference between the two groups was significant（P<0.05）. Conclusion Detemir in the treatment of gestational diabetes is effective and significantly improves maternal and infant outcomes， which is worthy of clinical promotion and application.

[Key words] Gestational diabetes; Maternal and infant outcomes; Fasting blood glucose; Postprandial 2h blood glucose; Glycated hemoglobin