地特胰岛素对妊娠期糖尿病的疗效及对母婴结局的影响(1)
[摘要] 目的 观察地特胰岛素治疗妊娠期糖尿病的疗效及对母婴结局的影响。 方法 选择2014 年3月～2016年3月妊娠期糖尿病患者80例作为研究对象，所有患者根据治疗方法不同随机分为观察组(地特胰岛素)和对照组(优泌林)，每组各40例。两组患者均予糖尿病饮食和运动治疗，对照组同时给予每日1 次优泌林N睡前注射；观察组予每日1次地特胰岛素睡前注射。比较两组患者治疗前后糖化血红蛋白水平的变化情况、两组胰岛素使用量及血糖达标时间、血糖达标率、低血糖发生率、严重低血糖发生率及母婴结局。 结果 观察组患者的胰岛素使用量明显少于对照组，观察组患者的血糖达标时间明显短于对照组(P<0.05)。观察组患者的血糖达标率显著高于对照组，观察组患者的低血糖发生率、严重低血糖发生率显著低于对照组(P<0.05)。观察组与对照组患者治疗前的糖化血红蛋白水平比较，差异无统计学意义；治疗3个月后，观察组与对照组患者的糖化血红蛋白水平显著降低，且于观察组患者治疗后的糖化血红蛋白水平显著低于对照组，组间比较差异有显著性(P<0.05)。观察组剖宫产、妊高症的发生率显著低于对照组，观察组早产发生率明显低于对照组，组间比较差异有显著性(P<0.05)。結论 地特胰岛素用于治疗妊娠期糖尿病疗效确切，可以显著降低血糖水平，并发症少，且可以明显改善母婴结局，值得推广和应用。
[关键词] 妊娠期糖尿病；地特胰岛素；母婴结局；妊高症；剖宫产
[中图分类号] R587.1 [文献标识码] B [文章编号] 1673-9701(2016)34-0054-03
Observation on the curative effect of insulin detemir on gestational diabetes mellitus and its effect on mother-infant outcome
LI Guoping LI Hongmei DU Hechun
Department of Gynecology and Obstetrics， Shaoxing Women and Children’s Hospital in Zhejing Province， Shaoxing 312000， China
[Abstract] Objective To observe the curative effect of insulin detemir in the treatment of gestational diabetes mellitus and its effect on mother-infant outcome. Methods 80 patients with gestational diabetes mellitus from March 2014 to March 2016 were selected as the study subjects. All the patients were randomly divided into two groups according to the different treatment methods： the observation group(insulin detemir) and the control group(Humulin)， with 40 patients in each group. Both groups were given diabetic diet and exercise therapy. The control group was injected with Humulin N once a day before sleep； the observation group was injected with insulin detemir once a day before sleep. Changes of the levels of glycosylated hemoglobin (HbA1c) before and after the treatment and dosage of insulin， as well as the standard rate of blood sugar， incidence rate of hypoglycemia， incidence rate of severe hypoglycemia and mother-infant outcome when the blood sugar was up to standards were compared between the two groups. Results The amount of insulin in the observation group was significantly less than that in the control group. The standard time of blood glucose in the observation group was shorter than that in the control group(P<0.05). The standard rate of blood glucose in the observation group was significantly higher than that in the control group. The incidence rates of hypoglycemia and severe hypoglycemia in the observation group were significantly lower than those in the control group(P<0.05). There was no significant difference in the levels of glycosylated hemoglobin between the observation group and the control group before treatment. After 3 months of treatment， the levels of glycosylated hemoglobin in the observation group and the control group were significantly decreased， and the level of glycosylated hemoglobin in the observation group was significantly lower than that in the control group after the treatment. There was a significant difference between the two groups(P<0.05). The incidence rates of cesarean section and pregnancy-induced hypertension in the observation group were significantly lower than those in the control group. The incidence rate of preterm birth in the observation group was significantly lower than that in the control group， and the differences were significant between the two groups(P<0.05). Conclusion Insulin detemir is effective in the treatment of gestational diabetes mellitus. It can significantly lower the blood sugar level， has less complications， and can significantly improve the mother-infant outcome， which is worthy of popularization and application. (李国平 李红梅 杜和春)
[关键词] 妊娠期糖尿病；地特胰岛素；母婴结局；妊高症；剖宫产
[中图分类号] R587.1 [文献标识码] B [文章编号] 1673-9701(2016)34-0054-03
Observation on the curative effect of insulin detemir on gestational diabetes mellitus and its effect on mother-infant outcome
LI Guoping LI Hongmei DU Hechun
Department of Gynecology and Obstetrics， Shaoxing Women and Children’s Hospital in Zhejing Province， Shaoxing 312000， China
[Abstract] Objective To observe the curative effect of insulin detemir in the treatment of gestational diabetes mellitus and its effect on mother-infant outcome. Methods 80 patients with gestational diabetes mellitus from March 2014 to March 2016 were selected as the study subjects. All the patients were randomly divided into two groups according to the different treatment methods： the observation group(insulin detemir) and the control group(Humulin)， with 40 patients in each group. Both groups were given diabetic diet and exercise therapy. The control group was injected with Humulin N once a day before sleep； the observation group was injected with insulin detemir once a day before sleep. Changes of the levels of glycosylated hemoglobin (HbA1c) before and after the treatment and dosage of insulin， as well as the standard rate of blood sugar， incidence rate of hypoglycemia， incidence rate of severe hypoglycemia and mother-infant outcome when the blood sugar was up to standards were compared between the two groups. Results The amount of insulin in the observation group was significantly less than that in the control group. The standard time of blood glucose in the observation group was shorter than that in the control group(P<0.05). The standard rate of blood glucose in the observation group was significantly higher than that in the control group. The incidence rates of hypoglycemia and severe hypoglycemia in the observation group were significantly lower than those in the control group(P<0.05). There was no significant difference in the levels of glycosylated hemoglobin between the observation group and the control group before treatment. After 3 months of treatment， the levels of glycosylated hemoglobin in the observation group and the control group were significantly decreased， and the level of glycosylated hemoglobin in the observation group was significantly lower than that in the control group after the treatment. There was a significant difference between the two groups(P<0.05). The incidence rates of cesarean section and pregnancy-induced hypertension in the observation group were significantly lower than those in the control group. The incidence rate of preterm birth in the observation group was significantly lower than that in the control group， and the differences were significant between the two groups(P<0.05). Conclusion Insulin detemir is effective in the treatment of gestational diabetes mellitus. It can significantly lower the blood sugar level， has less complications， and can significantly improve the mother-infant outcome， which is worthy of popularization and application. (李国平 李红梅 杜和春)