【摘要】：目的分析對(duì)比地特胰島素聯(lián)合門冬胰島素與精蛋白生物合成人胰島素聯(lián)合門冬胰島素治療妊娠合并糖尿病患者的安全性、有效性及分娩結(jié)局。方法選取2013年1月至2014年12月接受孕期檢查并分娩的需用基礎(chǔ)-餐前胰島素治療的妊娠合并糖尿病患者110例,其中,孕前糖尿病合并妊娠(PGDM)50例,GDM 60例,按1:1比例隨機(jī)分為地特胰島素組(Det,n=55)及精蛋白生物合成人胰島素組(NPH,n=55)。Det組予地特胰島素聯(lián)合門冬胰島素治療;NPH組予精蛋白生物合成人胰島素聯(lián)合門冬胰島素治療。對(duì)比兩組胰島素治療前后血糖變化、血糖達(dá)標(biāo)時(shí)間、治療期間低血糖發(fā)生率及分娩結(jié)局。結(jié)果治療1周后,與NPH組比較,Det組平均2 hPG[(7.6±1.1)vs(6.9±0.9)mmol/L]降低(P=0.001);Det組血糖達(dá)標(biāo)時(shí)間[FPG(7.1±3.2)vs(4.8±2.9)d;2 hPG(8.7±3.0)vs(5.7±3.6)d;FPG及2 hPG均達(dá)標(biāo)(10.9±2.8)vs(6.8±4.1)d]均縮短(P=0.000)。Det組及NPH組治療期間低血糖發(fā)生率分別為10.9%、25.5%,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。兩組分娩孕周、剖宮產(chǎn)率、妊娠期高血壓、巨大兒,新生兒低血糖、新生兒高膽紅素血癥、新生兒體重及轉(zhuǎn)NICU比較,差異均無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論對(duì)于妊娠合并糖尿病者,地特胰島素聯(lián)合門冬胰島素能更快、更有效地控制血糖,明顯減少注射次數(shù)和低血糖發(fā)生率,未增加不良分娩結(jié)局。
[Abstract]:Objective to analyze and compare the safety, efficacy and delivery outcome of Diet insulin combined with protophthora insulin and protamine biological synthetic human insulin combined with portal insulin in the treatment of gestational diabetes mellitus (GDM). Methods from January 2013 to December 2014, 110 pregnant patients with diabetes mellitus were selected, including 50 cases of pre-pregnancy diabetes mellitus complicated with gestational (PGDM) and 60 cases of GDM. According to the proportion of 1:1, they were randomly divided into two groups: Diet insulin group (Det,n=55) and protamine biosynchronous human insulin group (NPH,n=55). Det group treated with Diet insulin combined with insulin in winter), among them, 50 cases of prepregnancy diabetes complicated with diabetes mellitus and 60 cases of GDM were randomly divided into two groups according to the proportion of 1:1. NPH group was treated with protamine biosynthesized human insulin combined with asparagus insulin. The changes of blood glucose, the time of blood glucose reaching the standard, the incidence of hypoglycemia during treatment and the outcome of delivery were compared between the two groups before and after insulin treatment. Results one week after treatment, the mean 2 hPG [(7.6 鹵1.1) vs (6.9) mmol/L] in Det group was lower than that in NPH group [(7.1 鹵3.2) vs (4.8 鹵2.9) d vs 2 hPG (8.7 鹵3.0) vs (5.7 鹵3.6) d] in P 鈮，

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