胰岛素联合二甲双胍对妊娠期糖尿病患者血糖水平及新生儿神经发育的影响

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英文篇名：Effect of insulin combined with metformin on blood glucose level of patients with gestational diabetes mellitus and neonatal neurodevelopment 作者：张花蕊 英文作者：Zhang Huarui;Department Ⅱ of Obstetrics and Gynecology,Xinxiang Maternity & Child Health Hospital; 关键词：胰岛素 ; 二甲双胍 ; 妊娠期糖尿病 ; 新生儿 ; 神经发育 英文关键词：Insulin;;Metformin;;Gestational diabetes mellitus;;Neonate;;Neurodevelopment 中文刊名：GXBJ 英文刊名：Health Medicine Research and Practice 机构：新乡市妇幼保健院妇产二科; 出版日期：2018-12-20 出版单位：保健医学研究与实践 年：2018 期：v.15 基金：河南省科学技术厅资助项目(142300410383) 语种：中文; 页：GXBJ201806006 页数：4 CN：06 ISSN：50-1184/R 分类号：26-29

摘要

目的探究胰岛素联合二甲双胍对妊娠期糖尿病(GDM)患者血糖水平及新生儿神经发育的影响。方法选取河南省某医院2016年6月-2017年6月收治的104例GDM患者为研究对象,采用随机数字表法分为2组(对照组与研究组),每组52人。对照组患者单纯采用胰岛素治疗,研究组患者采用胰岛素联合二甲双胍治疗。比较2组患者分娩后的空腹血糖水平、餐后2h血糖水平以及血糖达标率,比较2组新生儿神经发育情况。结果分娩后,研究组患者空腹血糖水平及餐后2h血糖水平均低于对照组(P<0.05),研究组患者的血糖达标率高于对照组(P<0.05)。研究组新生儿神经行为测定(NBNA)评分法中的被动肌张力、主动肌张力、行为能力、原始反射、一般状态评分及NBNA评分总分均高于对照组(P<0.05)。此外,研究组新生儿的神经发育异常发生率低于对照组(P<0.05)。结论给予GDM患者胰岛素联合二甲双胍治疗,可有效控制患者的血糖水平,并可降低新生儿神经发育异常的发生率,值得推广。
        Objective To assess the effect of insulin combined with metformin on blood glucose level of patients with gestational diabetes mellitus(GDM)and neonatal neurodevelopment.Methods A total of 104 patients with GDM who were treated at a Henan hospital between June 2016 and June 2017 were included in this study.Based on a random number table,patients were divided into the trial group and the control group,52 in each group.Patients in the control group received insulin alone,while those in the trial group received insulin plus metformin.The postpartum fasting blood glucose,2 hpostprandial blood glucose level,proportion of patients achieving the target glucose level,as well as neonatal neurodevelopment were compared between the two groups.Results The postpartum fasting blood glucose and 2 hpostprandial blood glucose level were significantly lower in the trial group than those in the control group(P<0.05),and the proportion of patients achieving the target glucose level was also significantly higher in the trial group(P<0.05).The neonatal behavioral neurological assessment(NBNA)overall score as well as the passive muscle tension,active muscle tone,behavior ability,primitive reflection,and general assessment sub-scores were significantly higher in the trial group than those in the control group(P<0.05).Besides,the incidence of neonatal neurodevelopment abnormalities was significantly lower in the trial group compared with that in the control group(P<0.05).Conclusion For patients with GDM,insulin combined with metformin is effective in controlling the blood glucose level and minimizing the incidence of neonatal neurodevelopment abnormalities,which deserves widespread clinical application.

引文

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