【摘要】：目的：通過與胰島素比較，分析二甲雙胍和格列苯脲在妊娠期糖尿病（Gestational Diabetes Mellitus, GDM）中的安全性和有效性；方法：系統(tǒng)性檢索PubMed, EMBASE, the Cochrane Central Register ofControlled Trials (CENTRAL)，和中國生物醫(yī)學(xué)生物文獻(xiàn)數(shù)據(jù)庫，截至2013年12月有16篇隨機對照試驗包含二甲雙胍及格列苯脲與胰島素的比較。主要結(jié)果：本研究有2665例病例納入。在巨大兒方面，格列苯脲組多于胰島素組(OR=3.299,95%CI=1.649to6.600, P=0.001），而二甲雙胍組低于格列苯脲組(OR=0.234，95%CI=0.061to0.893，P=0.033)，二甲雙胍組與胰島素組無顯著差異（P=0.198）。在孕婦體重增加方面，二甲雙胍組明顯低于胰島素組（SMD=-0.539，95%CI=-0.716to-0.362，P=0.000）。妊娠時限方面，二甲雙胍明顯短于胰島素組（SMD=-0.142，95%CI=-0.246to-0.039，P=0.007）。結(jié)論：二甲雙胍控制血糖的療效好，，母親體重增加少，有更低的糖化血紅蛋白水平，且不增加母親低血糖風(fēng)險，但可能增加早產(chǎn)風(fēng)險。格列苯脲組有更高的巨大兒發(fā)生率。
[Abstract]:Objective: to analyze the safety and efficacy of metformin and glibenclamide in gestational diabetes mellitus (Gestational Diabetes Mellitus, GDM) by comparing with insulin. Methods: PubMed, EMBASE, the Cochrane Central Register ofControlled Trials (CENTRAL), and Chinese biomedical literature database were systematically searched. As of December 2013, 16 randomized controlled trials included metformin, glibenclamide and insulin. Main results: 2665 cases were included in this study. In macrosomia, glibenclamide group was more than insulin group (OR=3.299,95%CI=1.649to6.600, P0. 001), while metformin group was lower than glibenclamide group (OR=0.234,95%CI=0.061to0.893,P=0.033). There was no significant difference between metformin group and insulin group (P = 0.198). In weight gain, metformin group was significantly lower than insulin group (SMD=-0.539,95%CI=-0.716to-0.362,P=0.000). In pregnancy duration, metformin was significantly shorter than insulin group (SMD=-0.142,95%CI=-0.246to-0.039,P=0.007). Conclusion: metformin has a good effect on blood glucose control. Mothers have less weight gain, lower glycosylated hemoglobin level and less risk of hypoglycemia, but may increase the risk of premature delivery. The glibenclamide group had a higher incidence of macrosomia.
【學(xué)位授予單位】：重慶醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R587.1

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