中国药房2017，Vol.28Issue(15)：2032-2035,4.DOI:10.6039/j.issn.1001-0408.2017.15.05
胰岛素两种给药方式对高龄妊娠期糖尿病患者相关指标的影响比较
Comparison of the Effects of 2 Kinds of Administration Routes of Insulin on Related Indexes of Advanced Age Patients with Gestational Diabetes Mellitus
摘要
Abstract
OBJECTIVE:To compare the effects of repeated subcutaneous insulin administration vs. insulin pump continuous subcutaneous administration on related indexes of advanced age patients with gestational diabetes mellitus(GDM). METHODS:Inretrospective study,120 advanced age patients with GDM were randomly divided into group A(60 cases)and group B(60 cases). Group A was given Insulin aspart injection with initial dose of 0.5 U/(kg·d)subcutaneously before meal,adjusted according to fast-ing blood glucose(FPG)and postprandial 2 h blood glucose(2 hPG),and then given Isophane protamine biosynthetic human insu-lin injection with initial dose of 0.5 U/(kg·d)subcutaneously at bedtime,adjusted according to FPG and 2 hPG. Group B was giv-en Insulin aspart injection with initial dose of 0.5 U/(kg·d)added into insulin pump using 40% of total daily insulin as basic pump,increasing to 60% of total daily insulin if blood glucose control was poor,adjusted according to FPG and 2 hPG. Treatment course of 2 groups lasted for 4 weeks. The time of blood glucose reaching target,the amount of insulin were observed in 2 groups, and the levels of FPG,2 hPG,HbA1c,Hcy and Cys-C before and after treatment,the occurrence of patients and neonates compli-cations. RESULTS:The time of blood glucose reaching standard in group B was significantly shorter than group A;the amount of insulin,the incidence of hypoglycemia,premature birth,excessive amniotic fluid and gestational hypertension in group B were sig-nificantly lower than group A,with statistical significance(P<0.05). The incidence of neonatal respiratory distress syndrome in group B was significantly lower than group A,with statistical significance(P<0.05);but there was no statistical significance in the incidence of giant baby and malformation between 2 groups(P>0.05). After treatment,the levels of FPG,2 hPG,HbA1c,Hcy and Cys-C in 2 groups were significantly lower than before treatment,and the group B was significantly lower than the group A, with statistical significance(P<0.05). CONCLUSIONS:The insulin pump continuous subcutaneous administration is significantly better than repeated subcutaneous insulin administration in respects of controlling glucose level,reducing the amount of insulin,the levels of Cys-C and Hcy,maternal and neonatal complications.关键词
胰岛素/胰岛素泵/皮下给药/妊娠期糖尿病/血糖/并发症Key words
Insulin/Insulin pump/Subcutaneous administration/Gestational diabetes mellitus/Blood glucose/Complication分类
医药卫生引用本文复制引用
冯静,王新玲,李红艳,霍琰,刘素新..胰岛素两种给药方式对高龄妊娠期糖尿病患者相关指标的影响比较[J].中国药房,2017,28(15):2032-2035,4.基金项目
河北省医学科学研究重点课题计划(No.20150584) （No.20150584）
