门冬胰岛素治疗妊娠糖尿病的临床研究

目的探讨门冬胰岛素治疗妊娠糖尿病（GDM）的临床效果。方法将复旦大学附属中山医院分院2010年4月—2013年8月确诊的GDM初诊患者136例随机分为对照组和治疗组,每组68例。对照组餐前30 min皮下注射精蛋白生物合成人胰岛素注射液;治疗组每日3餐进食前皮下注射门冬胰岛素30注射液。对两组患者进行随访,比较其血糖控制情况、炎性因子及母婴结局。结果治疗后两组患者空腹血糖（FPG）、餐后2 h血糖（2 h PG）、糖化血红蛋白（Hb A1C）和尿C肽均明显好转,与治疗前差异具有统计学意义（P〈0.01）。治疗后,治疗组FPG、2 h PG、Hb A1C低于对照组,餐后0.5、2 h尿C肽高于对照组,两组比较差异有统计学意义（P〈0.05、0.01）。治疗组血糖达标时间、每日胰岛素用量、低血糖发生率均低于对照组,两组比较差异具有统计学意义（P〈0.05）。治疗后,两组患者C-反应蛋白（CRP）、白细胞介素6（IL-6）、和正五聚蛋白（PTX-3）均较治疗前显著降低,同组治疗前后差异具有统计学意义（P〈0.01）;治疗后,治疗组这些指标低于对照组,两组比较差异有统计学意义（P〈0.01）。两组患者母婴结局差异均无统计学意义,未出现严重不良反应。结论门冬胰岛素治疗妊娠糖尿病具有较好的临床疗效,可减少药物用量,缩短血糖达标时间,对GDM炎性症状改善良好,值得临床推广应用。

Clinical study on insulin aspart in treatment of gestational diabetes mellitus

Objective To explore the clinical effect of insulin aspart in the treatment of gestational diabetes mellitus（GDM）. MethodsNewly diagnosed patients with GDM（136 cases） in Zhongshan Hospital, Fudan University from April 2010 to August 2013 were randomly divided into control and treatment groups, and each group had 68 cases. The patients in the control group were sc administered with Isophane Protamine Biosynthetic Human Insulin Injection, while the patients in the treatment group were sc administered with Insulin Aspart 30 Injection before eating. Two groups of patients were followed up, and their blood sugar, inflammatory factors, and outcomes of maternal and neonatal in two groups were compared. Results After treatment, FPG, 2 h PG, Hb A1 C, and C peptide of two groups were significantly improved, and the difference was statistically significant in the same group before and after treatment（P〈0.01）. After treatment, FPG, 2 h PG, and Hb A1 C in treatment group were lower than those in the control group, while C peptide at 0.5 h and 2 h after meal in treatment group were higher than those in the control group, and there were differences between the two groups（P〈0.05, 0.01）. Blood glucose standard time, daily dosage of insulin, and hypoglycemia incidence in the treatment group were lower than those in the control group, and there were differences between the two groups（P〈0.05）. After treatment, CRP, IL-6, and PTX-3 in two groups were significantly reduced, and the difference was statistically significant in the same group before and after treatment（P〈0.01）. After treatment, the indicators in the treatment group were lower than those in the control group, and there were differences between the two groups（P〈0.01）. And outcomes of maternal and neonatal in two groups had no statistical significance, and patients in two groups did not appear serious adverse reactions. Conclusion Insulin aspart has the good clinical effect in the treatment of GDM, and can reduce drug and blood glucose