摘要
目的分析高剂量维生素D联合门冬胰岛素治疗妊娠期糖尿病(GDM)的疗效及对患者血糖代谢、视黄醇结合蛋白4(RBP4)、转化生长因子-β1(TGF-β1)和妊娠结局的影响。方法选取2017年1月—2018年5月我院收治的GDM患者168例,随机分为观察组、对照组,各84例,对照组予以低剂量维生素D联合门冬胰岛素,观察组予以高剂量维生素D及门冬胰岛素,1个月后观察二组血糖代谢相关指标[空腹血糖(FPG)、糖化血红蛋白(HbA1c)、胰岛素敏感指数(HOMA-IR)、胰岛素混合敏感指数(ISIcomp)]、维生素D水平、甲状旁腺激素功能相关指标[血钙、血磷、钙磷乘积、血清全段甲状旁腺激素(iPTH)]、血清RBP4、TGF-β1变化及妊娠结局。结果观察组治疗后FPG、HbA1c、HOMA-IR低于对照组,而ISIcomp高于对照组(P <0.05);治疗后观察组维生素D水平高于对照组,而维生素D异常率低于对照组(P<0.05);观察组治疗后血钙、钙磷乘积高于对照组,而血清iPTH低于对照组(P<0.05);观察组治疗后血清RBP4、TGF-β1低于对照组(P<0.05);观察组低血糖、胎膜早破、剖宫产及新生儿窒息、巨大儿发生率低于对照组,而新生儿Apgar评分高于对照组(P<0.05)。结论高剂量维生素D联合门冬胰岛素治疗GDM可较好改善患者血糖代谢水平,预防甲状腺功能亢进,并下调RBP4、TGF-β1,改善母婴结局,值得在临床推广应用。
Objective To analyze the efficacy of high-dose vitamin D combined with insulin aspart in the treatment of gestational diabetes mellitus(GDM)and its effects on blood glucose metabolism,retinol binding protein 4(RBP4),transforming growth factor-β1(TGF-β1)and pregnancy outcome.Methods One hundred and sixty-eight patients with GDM in Second People′s Hospital of Neijiang from January 2017 to May 2018 were enrolled in the study and randomly divided into observation group and control group,84 cases in each group.The control group was given low dose of vitamin D combined with insulin aspart,the observation group was given high dose of vitamin.D and insulin aspart.The blood glucose metabolism related indicators(fasting blood glucose(FPG),glycosylated hemoglobin(HbA1c),insulin sensitivity index(HOMA-IR),insulin mixed sensitivity index(ISIcomp)),vitamin D Level,parathyroid hormone function related indicators(blood calcium,blood phosphorus,calcium and phosphorus products,serum total parathyroid hormone(iPTH)),serum RBP4,TGF-β1 changes and pregnancy outcomes of two groups after 1 month were observed.Results After treatment,FPG,HbA1c,HOMA-IR in the observation group were lower than those in the control group,while ISIcomp was higher than those in the control group(P<0.05);after treatment,the level of vitamin D in the observation group was higher than that in the control group,while the abnormal rate of vitamin D was lower than that in the control group(P<0.05);the blood calcium,calcium and phosphorus products in the observation group were higher than those in the control group,the serum iPTH was lower than that in the control group(P<0.05).The serum RBP4 and TGF-β1 in the observation group were lower than those in the control group(P<0.05);the incidences of hypoglycemia,premature rupture of membranes,cesarean section,neonatal asphyxia,macrosomia in the observation group were lower than those in the control group,the Apgar score of neonates was higher than that of the control group(P<0.05).Conclusion High-dose vitamin D c
作者
黄香坤
杨建碧
谭鑫
Hunag Xiangkun;Yang Jianbi;Tan Xin(Department of Obstetrics,Second People′s Hospital of Neijiang,Neijiang 641000,China)
出处
《中国煤炭工业医学杂志》
2019年第4期346-350,共5页
Chinese Journal of Coal Industry Medicine
基金
四川省卫计委科研课题(编号:150283)
