胰岛素治疗妊娠糖尿病起始剂量与妊娠结局的相关性分析

目的探讨与分析胰岛素治疗妊娠糖尿病的起始剂量与妊娠结局的相关性。方法2015年5月—2018年12月选择诊治的106例妊娠糖尿病孕妇,根据随机数字表法分为低剂量组与高剂量组各53例。高剂量组:给予胰岛素1日多次给药治疗,门冬胰岛素注射液初始剂量0.5 U/(kg·d),低剂量组给予胰岛素泵持续治疗,门冬胰岛素注射液起始剂量0.2 U/(kg·d),两组疗程均为4周,记录两组妊娠结局。结果低剂量组的胰岛素用量显著低于高剂量组(P<0.05),两组血糖达标时间对比差异无统计学意义(P>0.05)。两组治疗后的FPG与2 hPG值都显著低于治疗前(P<0.05)。所有孕妇都顺利完成分娩,低剂量组的羊水过多、早产、妊娠期高血压、低血糖等并发症发生率为3.8%,显著低于高剂量组的24.5%(P<0.05)。低剂量组的新生儿高胆红素血症、新生儿低血糖、新生儿窒息、巨大儿等并发症发生率为3.8%,显著低于高剂量组的26.4%(P<0.05)。结论基于初始低剂量的胰岛素泵注射方式在妊娠糖尿病孕妇中的应用能减少胰岛素的应用剂量,能达到同样的降糖效果,改善孕妇与新生儿的预后。

Correlation Analysis Between the Initial Dose of Insulin Treatment for Gestational Diabetes and Pregnancy Outcome

Objective To explore and analyze the correlation between the initial dose of insulin for gestational diabetes and pregnancy outcome.Methods From May 2015 to December 2018,106 pregnant women with gestational diabetes were selected for diagnosis and treatment.They were divided into low-dose group and high-dose group with 53 cases according to the random number table method.High-dose group:Insulin was administered multiple times a day.The initial dose of insulin aspart was 0.5 U/(kg·d).The low-dose group was given continuous treatment with an insulin pump.The initial dose of insulin aspart was 0.2 U/(kg·d),the treatment course of both groups was 4 weeks,and the pregnancy outcomes of the two groups were recorded.Results The dosage of insulin in the low-dose group was significantly lower than that in the high-dose group(P<0.05),and there was no significant difference in blood glucose compliance time between the two groups(P>0.05).The FPG and 2 hPG values after treatment in both groups were lower before treatment(P<0.05).All pregnant women completed delivery successfully.The incidence of complications such as polyhydramnios,premature delivery,hypertension during pregnancy,and hypoglycemia in the low-dose group was 3.8%,which was significantly lower than 24.5%in the high-dose group(P<0.05).The complication rate of neonatal hyperbilirubinemia,neonatal hypoglycemia,neonatal asphyxia,and giant infants in the low-dose group was 3.8%,which was significantly lower than 26.4%in the high-dose group(P<0.05).Conclusion The application of the initial low-dose insulin pump injection method in pregnant women with gestational diabetes can reduce the dosage of insulin,achieve the same effect of lowering glucose,and improve the prognosis of pregnant women and newborns.