二甲双胍联合胰岛素疗法对妊娠期糖尿病患者血糖及母婴结局的影响

曾慧

[摘要]目的 探析二甲双胍联合胰岛素疗法对妊娠期糖尿病患者血糖及母婴结局的影响。方法 选取2018年1月～2019年6月沈阳市妇幼保健院收治的80例妊娠期糖尿病患者作为研究对象，根据随机数字表法将研究对象分为对照组和试验组，各40例。对照组采用胰岛素治疗，试验组采用二甲双胍与胰岛素联合治疗，对比两组的血糖水平、妊娠结局及新生儿不良结局。结果 试验组的空腹血糖、餐后2 h血糖、糖化血红蛋白水平均低于对照组，差异有统计学意义（P<0.05）;試验组高血压、剖宫产、子痫前期、早产发生率低于对照组，差异有统计学意义（P<0.05）;试验组的新生儿不良结局发生率低于对照组，差异有统计学意义（P<0.05）。结论 妊娠期糖尿病患者采用二甲双胍与胰岛素联合用药方案治疗，既可改善血糖水平，又可减少不良妊娠结局与新生儿不良结局，临床治疗安全性较高。

[关键词]妊娠期糖尿病;二甲双胍;胰岛素;联合用药;临床合理用药;临床效果;安全性

[中图分类号] R714.25          [文献标识码] A          [文章编号] 1674-4721（2020）6（b）-0132-03

[Abstract] Objective To explore the effect of Metformin combined with Insulin therapy on blood glucose and maternal and infant outcome of gestational diabetes mellitus （GDM）. Methods From January 2018 to June 2019， 80 patients with GDM admitted to Shenyang maternal and child health hospital were selected as the research objects. According to the random number table method， the research objects were divided into control group and experimental group， 40 cases in each group. The control group was treated with Insulin， and the experimental group was treated with Metformin and Insulin. The blood glucose level， pregnancy outcome and neonatal adverse outcome were compared between the two groups. Results The fasting blood glucose， 2 h postprandial blood glucose， and glycated hemoglobin levels in experimental group were lower than those in control group， the differences were statistically significant （P<0.05）; the rates of hypertension， cesarean section， pre-eclampsia and preterm delivery of the experimental group were lower than those in control group， the differences were statistically significant （P<0.05）; the incidence of adverse neonatal outcomes of the experimental group was lower than that in control group， the difference was statistically significant （P<0.05）. Conclusion The combined medication of Metformin and Insulin can not only improve the blood glucose level， but also reduce the adverse pregnancy outcome and neonatal adverse outcome. This treatment regimen is safe and worthy of clinical application.

[Key words] Gestational diabetes mellitus; Metformin; Insulin; Combined medication; Clinical rational use; Clinical effect; Safety

妊娠期糖尿病是产妇于妊娠过程中最常见的一种并发症，其是指妊娠前孕产妇无糖尿病史，处于妊娠期时，孕产妇出现糖尿病。根据临床相关资料[1-3]统计，目前妊娠期糖尿病发病率已达1%～14%，且我国妊娠期糖尿病发病率已达1%～5%，且近年来逐渐增高。因此，妊娠期糖尿病是一种高危性的妊娠并发症，会对孕妇与新生儿健康产生极大的影响，同时还会增加其他并发症，如早产、呼吸窘迫、低血糖、巨大儿、死亡等并发症[4]。……