二甲双胍联合CSII治疗GDM患者的效果研究(1)
【摘要】 目的：探究二甲双胍联合胰岛素泵连续皮下注射(continuous subcutaneous insulin infusion，CSII)治疗妊娠期糖尿病(gestational diabetes mellitus，GDM)患者的效果。方法：选取本院2016年5月-2018年1月收治的120例GDM患者作为研究对象，应用随机数字表法分为对照组与观察组，每组60例。对照组单用常规CSII治疗，观察组采用二甲双胍联合CSII治疗。比较两组治疗前后空腹血糖与餐后2 h血糖、相关指标与新生儿结局。结果：治疗后观察组空腹血糖与餐后2 h血糖均优于对照组(P<0.05);观察组子痫前期、早产、蛋白尿与胎膜早破发生率均低于对照组(P<0.05);观察组新生儿窒息、黄疸、低血糖与巨大儿发生率均明显低于对照组(P<0.05)。结论：二甲双胍联合CSII对于GDM患者的治療有积极作用，能够显著改善患者血糖指标，减少不良妊娠结局，同时显著降低新生儿黄疸、畸形、低血糖与巨大儿发生率，效果显著，值得大力推广。
【关键词】 二甲双胍; 胰岛素; 妊娠期糖尿病
Effect of Metformin Combined with CSII in Treatment of Patients with GDM/LAI Yongjing，LI Hongju，SUN Meiling，et al.//Medical Innovation of China，2019，16(24)：00-008
【Abstract】 Objective：To explore the effect of Metformin combined with continuous subcutaneous insulin infusion(CSII)in treatment of patients with gestational diabetes mellitus(GDM).Method：120 cases of patients with GDM treated in our hospital from May2016 to January2018 were selected as the research object.According to the random number table method they were divided into control group and observation group，60 cases in each group.The control group were treated with routine CSII alone，while the observation group were treated with Metformin combined with CSII.The fasting blood glucose and 2 h postprandial blood glucose before and after treatment，related indexes and neonatal outcome were compared between the two groups.Result：The fasting blood glucose and 2 h postprandial blood glucose in the observation group were better than those in the control group after treatment(P<0.05).The incidence of preeclampsia，preterm labor，proteinuria and premature rupture of membranes in the observation group were lower than those in the control group(P<0.05).The incidence of neonatal asphyxia，jaundice，hypoglycemia and macrosomia in the observation group were significantly lower than those in the control group(P<0.05).Conclusion：The treatment methods of Metformin combined with CSII for patients with GDM plays an active role，it can significantly improve patients’ blood glucose index and reduce adverse pregnancy outcomes，at the same time，significantly reduce the incidence of jaundice，deformity，hypoglycemia and macrosomia in neonates.The effects are significant，it is worth of promoting.
【Key words】 Metformin; Insulin; Gestational diabetes mellitus
First-author’s address：People’s Hospital of Rizhao，Rizhao 276800，China
doi：10.3969/j.issn.1674-4985.2019.24.002
妊娠期糖尿病(gestational diabetes mellitus，GDM)是妊娠期较为常见的并发症之一，据统计，GDM在我国发病率为1%～5%，且有逐年增长的趋势[1]。如不能有效控制GDM患者的病情，不仅是对产妇，也会对新生儿的结局产生不利影响，应该重视GDM的治疗。过去临床中治疗GDM采用胰岛素治疗，但会对孕妇和新生儿产生不可控的风险。二甲双胍是一种胰岛素的增敏剂，能够减轻肌肉和肝脏对于胰岛素的敏感性，从而提高胰岛素对血糖的控制作用，钱阔等[2]研究显示，采用二甲双胍联合胰岛素治疗GDM效果优于单用胰岛素，因此为探究这种用药的临床疗效，选取本院收治的120例GDM产妇作为研究对象，采用对比的方法，研究单用胰岛素和二甲双胍联合胰岛素两种方式的治疗效果，现报道如下。, 百拇医药(来永静 李洪菊 孙梅玲 秦丽丽 张益)
【关键词】 二甲双胍; 胰岛素; 妊娠期糖尿病
Effect of Metformin Combined with CSII in Treatment of Patients with GDM/LAI Yongjing，LI Hongju，SUN Meiling，et al.//Medical Innovation of China，2019，16(24)：00-008
【Abstract】 Objective：To explore the effect of Metformin combined with continuous subcutaneous insulin infusion(CSII)in treatment of patients with gestational diabetes mellitus(GDM).Method：120 cases of patients with GDM treated in our hospital from May2016 to January2018 were selected as the research object.According to the random number table method they were divided into control group and observation group，60 cases in each group.The control group were treated with routine CSII alone，while the observation group were treated with Metformin combined with CSII.The fasting blood glucose and 2 h postprandial blood glucose before and after treatment，related indexes and neonatal outcome were compared between the two groups.Result：The fasting blood glucose and 2 h postprandial blood glucose in the observation group were better than those in the control group after treatment(P<0.05).The incidence of preeclampsia，preterm labor，proteinuria and premature rupture of membranes in the observation group were lower than those in the control group(P<0.05).The incidence of neonatal asphyxia，jaundice，hypoglycemia and macrosomia in the observation group were significantly lower than those in the control group(P<0.05).Conclusion：The treatment methods of Metformin combined with CSII for patients with GDM plays an active role，it can significantly improve patients’ blood glucose index and reduce adverse pregnancy outcomes，at the same time，significantly reduce the incidence of jaundice，deformity，hypoglycemia and macrosomia in neonates.The effects are significant，it is worth of promoting.
【Key words】 Metformin; Insulin; Gestational diabetes mellitus
First-author’s address：People’s Hospital of Rizhao，Rizhao 276800，China
doi：10.3969/j.issn.1674-4985.2019.24.002
妊娠期糖尿病(gestational diabetes mellitus，GDM)是妊娠期较为常见的并发症之一，据统计，GDM在我国发病率为1%～5%，且有逐年增长的趋势[1]。如不能有效控制GDM患者的病情，不仅是对产妇，也会对新生儿的结局产生不利影响，应该重视GDM的治疗。过去临床中治疗GDM采用胰岛素治疗，但会对孕妇和新生儿产生不可控的风险。二甲双胍是一种胰岛素的增敏剂，能够减轻肌肉和肝脏对于胰岛素的敏感性，从而提高胰岛素对血糖的控制作用，钱阔等[2]研究显示，采用二甲双胍联合胰岛素治疗GDM效果优于单用胰岛素，因此为探究这种用药的临床疗效，选取本院收治的120例GDM产妇作为研究对象，采用对比的方法，研究单用胰岛素和二甲双胍联合胰岛素两种方式的治疗效果，现报道如下。, 百拇医药(来永静 李洪菊 孙梅玲 秦丽丽 张益)