王新英

[摘要] 目的 探討地特胰岛素治疗妊娠期糖尿病的疗效及对母婴结局的影响。 方法 选择2017年1月～2018年1月在我院住院的妊娠期糖尿病产妇100例为研究对象，随机分为观察组与对照组，每组各50例。两组均进行饮食控制及适当运动，每天三餐餐前使用门冬胰岛素0.3 U/kg，对照组予优泌林0.1 U/kg，每天1次，于睡前注射，观察组同时加用地特胰岛素0.1 U/kg，每天1次，于睡前注射;两组均连续治疗8周。治疗后比较两组的血糖控制情况及母婴结局。 结果 两组患者治疗后的空腹血糖、餐后2 h血糖及糖化血红蛋白水平分别显著低于治疗前，且观察组患者治疗后的空腹血糖、餐后2 h血糖及糖化血红蛋白水平显著低于对照组，两组血糖控制情况比较，差异有统计学意义（P<0.05）。观察组患者治疗后剖宫产、子痫前期、早产、胎膜早破、新生儿窒息、低血糖的发生率分别显著低于对照组， 差异有统计学意义（P<0.05）。 结论 地特胰岛素治疗妊娠期糖尿病疗效确切，显著改善母婴结局，值得临床推广和应用。

[关键词] 妊娠期糖尿病;母婴结局;空腹血糖;餐后2 h血糖;糖化血红蛋白

[中图分类号] R714.256          [文献标识码] B          [文章编号] 1673-9701（2019）04-0054-03

[Abstract] Objective To investigate the efficacy of insulin detemir in the treatment of gestational diabetes mellitus and its effect on maternal and fetal outcomes. Methods 100 puerperas with gestational diabetes mellitus admitted in our hospital from January 2017 to January 2018 were enrolled in the study. They were randomly divided into observation group and control group， with 50 cases in each group. Both groups were given diet control and appropriate exercise， and were given insulin aspart 0.3U/kg before three meals a day. The control group was given 0.1 U/kg of the eucalyptus before the bedtime， once a day. The observation group was added with the insulin detemir 0.1 U/kg， once a day， before bedtime. Both groups were continuously treated for 8 weeks. After treatment， the blood glucose control and maternal and fetal outcomes were compared between the two groups. Results The fasting blood glucose， postprandial 2 h blood glucose and glycosylated hemoglobin levels between the two groups after treatment were significantly lower than those before treatment. And the fasting blood glucose， postprandial 2 h blood glucose and glycosylated hemoglobin levels in the observation group were significantly lower than those in the control group. There was significant difference in the blood glucose control between the two groups（P<0.05）. The incidences of cesarean section， preeclampsia， premature delivery， premature rupture of membranes， neonatal asphyxia， and hypoglycemia were significantly lower in the observation group after treatment than those in the control group. The difference between the two groups was significant（P<0.05）. Conclusion Detemir in the treatment of gestational diabetes is effective and significantly improves maternal and infant outcomes， which is worthy of clinical promotion and application.

[Key words] Gestational diabetes; Maternal and infant outcomes; Fasting blood glucose; Postprandial 2h blood glucose; Glycated hemoglobin