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目的:比较胰岛素类似物门冬胰岛素与普通人胰岛素治疗妊娠糖尿病妇女的围产期结果。方法:将62例新诊断的饮食控制不达标的妊娠糖尿病妇女随机分为使用门冬胰岛素治疗组(Asp组)及使用普通人胰岛素治疗组(HI组),观察分娩时胰岛素用量(U/(kg.d))、羊水量(ml)、胎儿出生时体重(g)和身长(cm)、以及空腹及餐后血糖(mmol/L)、低血糖事件发生数等指标。结果:①Asp组分娩时羊水量显著低于HI组(417.0±13.2 ml vs 989.7±29.3 ml;P<0.05);同时Asp组餐后血糖显著低于HI组(6.5±0.4 mmol/L vs 9.3±1.5 mmol/L;P<0.05)。Asp组总计发生低血糖事件数为58次,而HI组总计发生低血糖事件数为203次。②羊水量与餐后血糖控制程度有正相关关系(r=0.72,P<0.05)。结论:门冬胰岛素能很好的控制餐后血糖,减少围产期羊水过多、巨大儿等风险,且能减少低血糖事件。
OBJECTIVE: To compare perinatal outcome of insulin analogue insulin aspart and common human insulin in women with gestational diabetes mellitus. Methods: Sixty-two newly diagnosed women with gestational diabetes who did not reach the standard of diet control were randomly divided into three groups: Asp group and normal human insulin group (HI group). The insulin dosage during delivery (U / ( kg), amniotic fluid volume (ml), weight at birth (g) and height (cm), as well as fasting and postprandial blood glucose (mmol / L) and incidence of hypoglycemic events. Results: (1) The amniotic fluid volume in Asp group was significantly lower than that in HI group (417.0 ± 13.2 ml vs 989.7 ± 29.3 ml; P <0.05), while the postprandial blood glucose in Asp group was significantly lower than that in HI group (6.5 ± 0.4 mmol / L vs 9.3 ± 1.5 mmol / L; P <0.05). The total number of hypoglycemic events in the Asp group was 58, while the total number of hypoglycemic events in the HI group was 203. ② The amount of amniotic fluid and postprandial blood glucose control has a positive correlation (r = 0.72, P <0.05). CONCLUSION: Aspart insulin can control postprandial blood glucose very well, reduce the risk of perinatal polyhydramnios and macrosomia, and reduce the incidence of hypoglycaemia.