葛根素联合门冬胰岛素对妊娠期糖尿病患者氧化应激、胰岛素抵抗及胰岛β细胞功能的影响

摘要

Objective To observe the effects of puerarin combined with insulin aspart on oxidative stress, insulin resistance and pancreatic β-cell function in pregnant women with gestational diabetes mellitus (GDM).Methods A total of 100 patients with GDM who were admitted and treated in our hospital from June 2013 to December 2015 were randomly divided into observation group ( n =50) and control group ( n =50).The patients in control group were treated by insulin aspart, however,the patients in observation group,on the basis of control group, were treated by puerarin combined with insulin aspart.After treatment,the levels of fasting blood glucose (FBG), 2 hours postprandial blood glucose (2hPBG), glycosylated hemoglobin (HbA1c), nighttime blood glucose, the activities of glutathione peroxidase (GSH-PX), superoxide dismutase (SOD), reactive oxygen species ( ROS), malondialdehyde ( MDA), fasting insulin ( FINS), homeostasis model HOMAβ-cell function index (HOMA-β), insulin resistance index (HOMA-IR), insulin sensitivity index (ISI), insulin secretion index (ΔI30 /ΔG30 ) and mixed insulin sensitivity (ISI comp) were detected and compared between two groups.Results After treatment, The levels of FBG,2 hPBG,HbA1c,ROS,MDA,FINS,HOMA-IR were significantly decreased,as compared with those before treatment in both groups,however the levels of GSH-IPX, SOD,HOMA-β,ISI,ΔI30 /ΔG30 and ISIcomp were significantly increased,as compared with those before treatment in both groups ( P <0.05).But the improvement degree of the indexes mentioned above in observation group was superior to that in control group ( P <0.05).Conclusion The puerarin combined with insulin aspart can effecetively decrease the levels of blood glucose in pregnant women with GDM,and can improve the disbalance of serum oxidation and antioxidative materials,moreover,which can improve insulin resistance and protect islet β-cell function.%目的：观察葛根素联合门冬胰岛素对妊娠期糖尿病（GDM）患者血清氧化相关物质、胰岛素抵抗及胰岛β细胞功能的影响。方法GDM 患者100例随机分为对照组和观察组，每组50例。对照组给予门冬胰岛素治疗，观察组在对照组基础上加用葛根素注射液治疗。比较2组空腹血糖（FBG）、餐后2 h 血糖（2 hPBG）、糖化血红蛋白（HbA1c）、夜间血糖、谷胱甘肽过氧化物酶（GSH－PX）、超氧化物歧化酶（SOD）、活性氧（ROS）、丙二醛（MDA）活性、空腹胰岛素（FINS）、胰岛β细胞功能指数（HOMA－β）、胰岛素抵抗指数（HOMA－IR）、胰岛素敏感指数（ISI）、胰岛素分泌指数（ΔI30／ΔG30）、混合胰岛素敏感度（ISIcomp）变化。结果2组治疗后 FBG、2 hPBG、HbA1c、ROS、MDA、FINS、HO－MA－IR 较治疗前显著降低，GSH－PX、SOD、HOMA－β、ISI、ΔI30／ΔG30、ISIcomp 较治疗前显著升高（ P ＜0．05），但观察组以上指标改善程度优于对照组，差异有统计学意义（ P ＜0．05）。结论葛根素联合门冬胰岛素能够有效降低妊娠期糖尿病患者血糖水平，纠正患者血清氧化和抗氧化物质失衡、改善胰岛素抵抗、保护胰岛β细胞功能。