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目的:探讨二甲双胍联合门冬胰岛素对妊娠期糖尿病患者血清胆固醇(TC)、总胆红素(TBil)、尿酸(UA)、尿微量蛋白(mAlb)水平及母婴结局的影响。方法:选择2014年6月至2016年6月我院接诊的84例妊娠期糖尿病患者,通过随机数表法分为观察组(n=42)和对照组(n=42)。在常规治疗基础上,对照组使用门冬胰岛素治疗,观察组再联合盐酸二甲双胍。比较两组治疗前后血糖指标、TC、TBil、UA、m Alb的变化以及母婴结局。结果:治疗后,观察组空腹血糖(FBG)、餐后2h血糖(2hPG)、糖化血红蛋白(HbA1c)、TC、UA、m Alb水平均显著低于对照组(P<0.05),TBil水平明显高于对照组(P<0.05),妊娠期高血压、羊水过多、早产、剖宫产、巨大儿、新生儿黄疸的发生率均显著低于对照组(P<0.05)。结论:二甲双胍联合门冬胰岛素对妊娠期糖尿病患者的疗效显著,可有效改善患者血糖指标以及TC、TBil、UA、m Alb水平,改善母婴结局。
Objective: To investigate the effects of metformin combined with aspart insulin on serum cholesterol (TC), total bilirubin (TBil), uric acid (UA), urinary microalbumin (mAb) and maternal and infant outcomes in patients with gestational diabetes mellitus. Methods: 84 cases of gestational diabetes admitted to our hospital from June 2014 to June 2016 were divided into observation group (n = 42) and control group (n = 42) by random number table. On the basis of routine treatment, the control group was treated with insulin aspart and the observation group combined with metformin hydrochloride. The changes of blood glucose, TC, TBil, UA and m Alb before and after the treatment were compared between the two groups. Results: After treatment, FBG, 2hPG, HbA1c, TC, UA and m Alb in observation group were significantly lower than those in control group (P <0.05), TBil level was significantly higher in observation group The incidences of gestational hypertension, polyhydramnios, premature delivery, cesarean section, macrosomia and neonatal jaundice in the control group were significantly lower than those in the control group (P <0.05). CONCLUSION: Metformin combined with aspart insulin has significant therapeutic effect on gestational diabetes mellitus, which can effectively improve the level of blood glucose, the level of TC, TBil, UA and m Alb, and improve the maternal and infant outcomes.