硒补充剂对妊娠期糖尿病患者血糖和血脂代谢及妊娠结局的影响分析

目的探讨硒补充剂对妊娠期糖尿病患者血糖、血脂代谢和妊娠结局的影响。方法将2018年7月-2019年6月盘锦市中心医院收治的45例妊娠期糖尿病患者随机分为对照组21例和硒酵母组24例。两组患者均给予健康教育、饮食指导、运动指导等常规治疗,硒酵母组在常规治疗基础上给予硒酵母片治疗。比较两组治疗前后空腹血糖、胰岛素抵抗指数、总胆固醇、甘油三酯、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇水平及妊娠结局。结果治疗后两组空腹血糖和胰岛素抵抗指数均较治疗前下降,且硒酵母组两项指标均低于对照组,差异均具有统计学意义(P<0.05)。治疗后两组孕妇总胆固醇、甘油三酯、低密度脂蛋白胆固醇水平较治疗前下降,且硒酵母组三项指标水平低于对照组,差异均具有统计学意义(P<0.05)。治疗后硒酵母组高密度脂蛋白胆固醇水平高于治疗前,差异具有统计学意义(P<0.05)。对照组治疗前后以及两组治疗后高密度脂蛋白胆固醇水平差异均无统计学意义(P>0.05)。硒酵母组新生儿高胆红素血症发生率和新生儿住院率均低于对照组,差异均具有统计学意义(P<0.05)。两组其他不良妊娠结局差异均无统计学意义(P>0.05)。结论硒补充剂能够进一步改善妊娠期糖尿病患者的血糖和血脂代谢,同时,也能降低新生儿高胆红素血症发生率和住院率,值得推广使用。

Effect of Selenium Supplement on Blood Glucose,Lipid Metabolism and Pregnancy Outcome in Gestational Diabetes Mellitus

Objective To investigate the effects of selenium supplementation on blood glucose, lipid metabolism and pregnancy outcome in gestational diabetes mellitus. Methods A total of 45 cases of gestational diabetes mellitus admitted to Panjin Central Hospital from July 2018 to June 2019 were randomly divided into control group(21 cases) and selenium yeast group(24 cases). Both groups were given routine treatment, such as health education,diet guidance and exercise guidance. The selenium yeast group was given selenium yeast tablets on the basis of routine treatment. The fasting blood glucose(FBG), homeostasis model assessment insulin resistance(HOMA-IR),total cholesterol(TC), triglyceride(TG), low density lipoprotein cholesterol(LDL-C) and high density lipoprotein cholesterol(HDL-C) levels before and after treatment, and pregnancy outcomes were compared between the two groups. Results After treatment, FBG and HOMA-IR in the two groups decreased compared with those before treatment, and the two indexes in selenium yeast group were significantly lower than those in the control group(P <0.05). After treatment, the levels of TC, TG and LDL-C in the two groups were significantly lower than those before treatment, and the levels of three indexes in the selenium yeast group were significantly lower than those in the control group(P < 0.05). After treatment, the level of HDL-C in selenium yeast group was significantly higher than that before treatment(P < 0.05). There was no significant difference in the level of HDL-C before and after treatment of the control group and after treatment between the two groups(P > 0.05). The incidence of neonatal hyperbilirubinemia and neonatal hospitalization rate in selenium yeast group were significantly lower than those in the control group(P < 0.05). There was no significant difference in other adverse pregnancy outcomes between the two groups(P > 0.05).Conclusion Selenium supplementation can further improve blood glucose and lipid metabolism in patients with gestational diabetes mellitus, and can also reduce the incidence of neonatal hyperbilirubinemia and hospitalization rate, which is worth promoting.