胰岛素泵双波疗法对妊娠期糖尿病患者妊娠结局的影响

摘要

目的:探讨胰岛素泵双波疗法对妊娠期糖尿病患者血糖控制及妊娠结局的影响.方法:将妊娠期糖尿病患者86例分为观察组和对照组各43例.对照组采用胰岛素泵常规波疗法治疗,观察组采用胰岛素泵双波疗法治疗.观察比较两组血糖达标时间、胰岛素用量、低血糖发生率.采用动态血糖监测系统检测两组血糖波动情况,包括平均血糖值(MBG)、平均血糖漂移幅度(MAGE)、早餐后血糖漂移幅度(BPPGE)、午餐后血糖漂移幅度(LPPGE)、晚餐后血糖漂移幅度(DPPGE)、最低血糖波动幅度(LAGE).对比两组的妊娠结局.结果:观察组血糖达标时间低于对照组(P＜0.05);胰岛素用量、治疗费用、低血糖发生率、MBG两组无差异(P＞0.05);MAGE、BPPGE、LPPGE、DPPGE、LAGE观察组低于对照组(P＜0.05);剖宫产、巨大胎儿观察组低于对照组(P＜0.05).结论:胰岛素泵双波疗法能显著改善妊娠期糖尿病的血糖控制情况,降低剖宫产及巨大胎儿的发生率.%Objective:To investigate the effect of insulin pump therapy on pregnancy outcome of women with gestational diabetes mellitus (GDM).Methods:86 women with GDM were divided into study group and control group (43 women in each group).Pregnant women in study group were treated by insulin pump double wave therapy,and preg nant women in control group were treated by routine insulin pump.The time of blood glucose up to standard,insulin dosage,and incidence of hypoglycemia of pregnant women were compared between the two groups.The blood glucose fluctuation of pregnant women in both groups were monitored by dynamic blood glucose monitoring system,which included mean blood glucose (MBG),the mean amplitude of glucose excursion (MAGE),after breakfast amplitude of glucose excursion (BPAGE),after lunch amplitude of glucose excursion (LPAGE),after supper amplitude of glucose excursion (SPAGE),the low amplitude of volatility (LAGE),and the pregnancy outcomes.Results:The time of blood glucose returned to normal of pregnant women in study group was significantly lower than that of pregnant women in the control group (P＜0.05).There was no significantly difference in insulin dosage,treatment cost,incidence of hypoglycemia or MBG between the two groups (P ＞0.05).But MAGE,BPPGE,LPPGE,DPPGE and LAGE of pregnant women in study group were significantly lower than those of pregnant women in the control group (P＜0.05).Rate of cesarean section and fetal macrosomia in study group were significantly lower than those in control group (P＜0.05).Conclusion:Insulin pump double wave therapy can significantly improve the blood glucose control of women with GDM,and can reduce the incidence of cesarean section and fetal macrosomia.