门冬胰岛素治疗GDM的疗效及其对患者氧化应激指标妊娠结局的影响

摘要

目的 探讨门冬胰岛素治疗妊娠期糖尿病(GDM)的疗效及其对患者氧化应激指标、妊娠结局的影响.方法 2015年7月至2017年6月收治的90例GDM患者,采取随机数字表将其分成两组,每组各45例.其中观察组给予门冬胰岛素治疗,对照组给予生物合成人胰岛素治疗,比较两组血糖控制效果、氧化应激指标变化情况以及妊娠结局.结果 两组患者治疗后FPG、2hPG、HbA1c水平均较治疗前显著降低(P<0.01),但观察组各项血糖指标降低更明显(P<0.01).观察组血糖达标时间显著短于对照组,胰岛素用量及低血糖发生率均显著低于对照组(P<0.05).两组治疗后血清GSH-PX、SOD水平均较治疗前显著升高,MDA水平显著降低(P<0.01);两组治疗后比较差异无统计学意义(P>0.05).两组阴道分娩率、羊水过多、胎儿宫内窘迫、胎膜早破、早产、巨大儿、产后出血发生率比较差异无统计学意义(P>0.05).结论 门冬胰岛素治疗GDM可显著提高患者的血糖控制效果,改善血清氧化应激指标,减少低血糖的发生率,值得推广应用.%Objective To investigate the efficacy of insulin aspart in the treatment of gestational diabetes mellitus(GDM)and its influence on the oxidative stress index and pregnancy outcome.Methods90 patients with GDM were treated in our hospital from July 2015 to June 2017. They were divided into two groups by random number table,45 cases in each group. Among them,the observation group was treated with insulin aspart,and the control group was treated with biosynthetic human insulin. The effects of blood glucose control,the changes of oxidative stress index and pregnancy outcome were compared between the two groups.ResultsAfter treatment,the levels of FPG,2hPG and HbA1c in the two groups were significantly lower than those before treatment(P<0.01),but the indexes of blood glucose in the observation group decreased more significantly(P<0.01). The blood glucose reaching time of the observation group was significantly shorter than that of the control group,and the dosage of insulin and the incidence of hypoglycemia were significantly lower than those of the control group(P<0.05). The serum levels of GSH-PX and SOD were significantly higher than those before treatment,and the level of MDA decreased significantly(P<0.01). There was no significant difference between the two groups after treatment(P>0.05)(two). The rates of vaginal delivery,amniotic fluid overload,fetal distress,premature rupture of membranes, premature delivery,macrosomia and postpartum hemorrhage were not significantly different between the two groups(P>0.05).ConclusionInsulin aspart treatment of GDM can significantly improve the blood glucose control effect,improve the serum oxidative stress index,reduce the incidence of hypoglycemia,and is worthy of popularization and application.