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目的探讨维生素D辅助治疗妊娠糖尿病的效果。方法选择2014年2月—2015年2月来本院就诊的70例妊娠糖尿病患者作为研究对象,随机分为两组各35例。对照组采用常规胰岛素方案治疗,观察组在对照组基础上联合应用维生素D,观察两组治疗效果。计量资料用x—±s表示,两组间比较采用独立样本t检验,组内比较采用配对t检验,P<0.05为差异有统计学意义。结果治疗后两组患者的空腹血糖值(fasting blood glucose,FBG)、糖化血红蛋白(glycosylated hemoglobin,HbAlc)及餐后2h血糖(postprandial 2 hours blood glucose,2 h PG)[(4.54±0.43)mmol/L、(6.03±0.26)%、(8.02±1.03)mmol/L与(5.32±0.61)mmol/L、(5.69±0.24)%、(7.36±1.14)mmol/L]比较,差异均有统计学意义(均P<0.05)。两组患者治疗前后各指标比较,差异均有统计学意义(t=19.254、5.102、10.954、17.048、23.957、13.191,均P<0.05)。治疗后两组患者的胰岛素抵抗指数(insulin resistance index,HOMA-IR)、HOMA-β、视黄醇结合蛋白4(reti nol-blinding protein-4,RBP4)、内脂素(Visfatin)、肿瘤坏死因子-α(tumor necrosis factor alpha,TNF-α)、脂联素(adiponectin,APN)、25-(OH)D_3[(2.57±0.39)、(0.87±0.18)%、(44.26±1.20)mmol/L、(8.23±0.21)ng/ml、(103.52±4.11)ng/ml、(310.51±15.22)pg/ml、(18.94±6.02)ng/L与(3.36±0.42)、(0.98±0.22)%、(45.23±1.14)mmol/L、(6.24±0.23)ng/ml、(68.51±3.83)ng/ml、(321.47±16.10)pg/ml、(25.21±7.12)ng/L]比较,差异均有统计学意义(均P<0.05)。两组患者治疗前后各指标比较,差异均有统计学意义(t=11.219、39.299、9.942、4.276、2.222、6.332、2.671、8.586、14.907、4.785、2.075、22.779、17.870、30.254,均P<0.05)。结论维生素D辅助治疗妊娠糖尿病效果显著,维生素D可能通过调节脂肪和炎症因子水平、胰岛素敏感性发挥治疗作用。
Objective To investigate the effect of vitamin D adjuvant therapy on gestational diabetes mellitus. Methods Seventy patients with gestational diabetes who visited our hospital from February 2014 to February 2015 were selected as study subjects and randomly divided into two groups of 35 cases each. The control group was treated with conventional insulin regimen. The observation group was treated with vitamin D on the basis of the control group, and the therapeutic effect was observed. Measurement data with x- ± s, said two groups were compared using independent samples t test, the group was compared using paired t test, P <0.05 for the difference was statistically significant. Results After treatment, the fasting blood glucose (FBG), glycosylated hemoglobin (HbAlc) and postprandial 2h blood glucose (2h PG) [(4.54 ± 0.43) mmol / L, (6.03 ± 0.26)%, (8.02 ± 1.03) mmol / L and (5.32 ± 0.61) mmol / L, (5.69 ± 0.24)% and (7.36 ± 1.14) mmol / L] Significance (all P <0.05). The two groups of patients before and after treatment of each index, the differences were statistically significant (t = 19.254,5.102,10.954,17.048,23.957,13.191, all P <0.05). After treatment, the insulin resistance index (HOMA-IR), HOMA-β, reti nol-blinding protein-4 (RBP4), visfatin, tumor necrosis TNF-α, adiponectin (APN), 25- (OH) D_3 [(2.57 ± 0.39), (0.87 ± 0.18)%, (44.26 ± 1.20) mmol / L, (8.23 ± 0.21) ng / ml, (103.52 ± 4.11) ng / ml, (310.51 ± 15.22) pg / ml, (18.94 ± 6.02) ng / L and (3.36 ± 0.42) , (45.23 ± 1.14) mmol / L, (6.24 ± 0.23) ng / ml, (68.51 ± 3.83) ng / ml, (321.47 ± 16.10) pg / ml and (25.21 ± 7.12) ng / L] There was statistical significance (all P <0.05). The two groups of patients before and after treatment of each index, the differences were statistically significant (t = 11.219,39.299,9.942,4.276,2.222,6.332,2.671,8.586,14.907,4.785,2.075,22.779,17.870,30.254, all P <0.05 ). Conclusion Vitamin D adjuvant treatment of gestational diabetes mellitus significantly, vitamin D may play a therapeutic role by regulating the level of fat and inflammatory cytokines, insulin sensitivity.