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目的:探讨早期服用二甲双胍对妊娠肥胖患者妊娠糖尿病的预防作用及对胎儿体重影响。方法:选取我院收治的54例妊娠肥胖患者,参照随机数字表法分成两组,每组27例。对照组患者给予运动方案治疗,无药物干预;研究组患者在对照组基础上给予二甲双胍。分别于生产前后检测患者血清空腹血糖(FBG)、餐后两小时血糖(2hPG)、糖化血红蛋白(HbA1C)、胰岛素(INS)以及C肽水平,并比较产后妊娠糖尿病患病率及胎儿体重。结果:生产后,研究组妊娠糖尿病患病率及胎儿异常发生率较对照组明显降低(P<0.05);与生产前比较,研究组FBG、2hPG、HbA1C、血清INS以及C肽水平无明显差异(P>0.05),对照组FBG、2hPG、HbA1C、血清INS以及C肽水平显著升高(P<0.05)。两组不良反应的发生率比较差异无明显意义(P>0.05)。结论:早期服用二甲双胍能有效预防妊娠肥胖患者发生妊娠糖尿病,可保持胎儿体重正常增长。
Objective: To explore the preventive effect of early metformin on gestational diabetes mellitus in pregnant women with obesity and its effect on fetal body weight. Methods: 54 cases of pregnancy-induced obesity admitted to our hospital were divided into two groups according to the random number table, with 27 cases in each group. Patients in the control group were treated with exercise regimen without drug intervention; patients in the study group were given metformin on the basis of the control group. The levels of fasting blood glucose (FBG), two hours postprandial blood glucose (2hPG), HbA1C, INS and C-peptide levels were measured before and after production. The prevalence of postpartum gestational diabetes mellitus and fetal body weight were compared. Results: The incidence of gestational diabetes mellitus and fetal abnormality in study group were significantly lower than those in control group after birth (P <0.05). There were no significant differences in FBG, 2hPG, HbA1C, serum INS and C-peptide levels (P> 0.05). The levels of FBG, 2hPG, HbA1C, INS and C peptide in the control group were significantly increased (P <0.05). There was no significant difference between the two groups in the incidence of adverse reactions (P> 0.05). Conclusion: Early metformin can effectively prevent gestational diabetes in gestational obese patients and keep the normal weight of the fetus.