二甲双胍与胰岛素对妊娠糖尿病母婴结局的Meta分析

摘要

Objective To systematically evaluate the maternal and neonatal outcomes of metformin and insulin for the treatment of gestational diabetes by Meta-analysis system.Methods Randomized controlled trials of metformin and insulin for treatment of gestational diabetes were collected by searching CNKI,WANFANG,CBM and PubMed databases.Meta-analysis was operated by RevMan 5.3 software.Results A total of 12 pieces of literature were included with a total of 1 008 cases.Meta-analysis showed that compared with insulin,metformin obviously decreased the occurrence of complications including preeclampsia[OR=0.21,95% CI (0.11,0.39),P<0.01],cesarean section[OR=0.63,95% CI(0.47,0.84),P=0.002],macrosomia[OR=0.29,95% CI(0.17, 0.49),P<0.01],respiratory distress[OR=0.40,95% CI(0.30,0.79),P<0.01],hypoglycemia[OR=0.34,95% CI(0.20, 0.56),P<0.01]and jaundice[OR = 0.26,95% CI(0.16,0.41),P< 0.01].Conclusion Metformin shows better effect than insulinfor on treatment of gestational diabetes.%目的 系统评价二甲双胍与胰岛素对妊娠糖尿病患者母婴结局影响.方法 通过检索中国知网(CNKI)、维普、万方数据库、中国生物医学文献数据库(CBM)及PubM ed数据库,收集二甲双胍与胰岛素治疗妊娠糖尿病并发症的随机对照试验,采用Rev M an 5.3软件进行M eta分析.结果 共纳入文献12篇,累计患者1008例.M eta分析结果显示,二甲双胍与胰岛素相比,能够显著降低妊娠糖尿病母婴并发中子痫前期(OR=0.21,95% CI:0.11~0.39,P<0.01)、剖宫产(OR=0.63,95% CI:0.47~0.84,P<0.01)、巨大儿(OR=0.29,95% CI:0.17~0.49,P<0.01)、呼吸窘迫(OR=0.40,95% CI:0.30~0.79,P<0.01)、低血糖(OR=0.34,95% CI:0.20~0.56,P<0.01)和黄疸例数(OR=0.26,95% CI:0.16~0.41,P<0.01).结论 二甲双胍对妊娠糖尿病患者并发症的母婴结局影响优于胰岛素.