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目的探讨胰岛素对妊娠期糖尿病(GDM)孕晚期产妇血脂水平及新生儿出生体重的影响,为临床治疗提供参考。方法选择2013年6月至2015年1月收治的100例患GDM的孕晚期产妇,按随机数字表法分为观察组(50例)和对照组(50例)。观察组在常规的产前护理基础上,在餐前进行胰岛素治疗,对照组患者进行常规的产前护理和饮食、运动治疗。比较分析两组患者治疗后临床指标及血脂水平、治疗效果、新生儿体重和不良反应情况。结果两组患者高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、胆固醇水平比较均无统计学差异(P均>0.05)。观察组患者甘油三酯[(3.62±1.52)mmol/L vs(4.89±2.43)mmol/L]、空腹血糖[(5.08±1.07)mmol/L vs(7.46±1.93)mmol/L]水平均明显低于对照组(P均<0.01)。观察组治疗有效率为80.00%,明显高于对照组的54.00%(P<0.01)。观察组新生儿正常体重率为86.00%,明显高于对照组的56.00%(P<0.01)。观察组患者不良反应发生率为24.00%,明显低于对照组的44.00%(P<0.05)。结论胰岛素治疗妊娠期糖尿病孕晚期产妇,疗效显著,可有效降低产妇血糖、血脂水平,减少巨大儿的出生,提高正常体重新生儿的出生率,且不良反应少。
Objective To investigate the effect of insulin on maternal serum lipids and neonatal birth weight in gestational diabetes mellitus (GDM) in the third trimester of pregnancy, and provide a reference for clinical treatment. Methods 100 maternal women with third trimester GDM who were admitted to our hospital from June 2013 to January 2015 were randomly divided into observation group (50 cases) and control group (50 cases). On the basis of routine prenatal care, the observation group received insulin treatment before meals and the control group received routine prenatal care and diet and exercise therapy. The clinical indexes, blood lipid level, therapeutic effect, neonatal weight and adverse reactions were compared between the two groups after treatment. Results There was no significant difference in HDL-C, LDL-C and cholesterol between the two groups (P> 0.05). The level of triglyceride in observation group [(3.62 ± 1.52) mmol / L vs (4.89 ± 2.43) mmol / L] and fasting blood glucose [(5.08 ± 1.07) mmol / L vs (7.46 ± 1.93) mmol / L] Lower than the control group (P <0.01). The observation group treatment efficiency was 80.00%, significantly higher than the control group 54.00% (P <0.01). The normal newborn weight rate in the observation group was 86.00%, which was significantly higher than that in the control group (56.00%, P <0.01). The incidence of adverse reactions in the observation group was 24.00%, which was significantly lower than that in the control group (44.00%, P <0.05). Conclusion Insulin treatment of gestational diabetes in third trimester of pregnant women, the curative effect is significant, can effectively reduce maternal blood sugar, blood lipid levels, reduce the birth of huge children, increase the birth rate of normal weight neonates, and less adverse reactions.