摘要
目的探究门冬胰岛素注射液联合维生素D对妊娠期糖尿病孕妇母婴结局及血清视黄醇结合蛋白-4(RBG-4)、糖化血红蛋白(HbA1c)水平的影响。方法选取2020年8月至2024年5月于邢台市中心医院就诊的116例妊娠期糖尿病孕妇为研究对象,经中心随机法分为试验组和对照组,每组58例,其中对照组采用门冬胰岛素注射液治疗,试验组在对照组基础上联合维生素D治疗。记录两组母婴不良结局发生率;于治疗前及治疗1个月后,比较两组血清糖代谢相关指标[胰岛β功能指数(HOMA-β)、HbA1c、RBG-4]、血清内环境改善相关指标[骨化三醇(1,25(OH)_2D_3)、血钙]、脂代谢相关指标[脂联素(APN)、脂肪素(VF)]和疾病相关生化指标[脂蛋白相关磷脂酶A_2(Lp-PLA_2)、血管细胞黏附分子-1(VCAM-1)]水平。结果试验组母婴不良结局发生率低于对照组,但差异无统计学意义(P>0.05)。治疗1个月后,两组HOMA-β、APN、1,25(OH)_2D_3、血钙水平均高于治疗前,且试验组高于对照组(P<0.05);两组HbA1c、RBG-4、VF、Lp-PLA_2、VCAM-1水平均低于治疗前,且试验组低于对照组(P<0.05)。结论门冬胰岛素注射液联合维生素D对妊娠期糖尿病孕妇的治疗效果良好,能提高糖脂代谢,促进胰岛β细胞功能恢复,缓解胰岛素抵抗,改善母婴不良结局。
Objective To explore the effects of insulin aspart injection combined with vitamin D on maternal-infant outcomes and levels of serum retinol binding protein-4(RBG-4)and glycosylated hemoglobin(HbA1c)in pregnant women with gestational diabetes mellitus(GDM).Methods A total of 116 pregnant women with GDM who received treatment in Xingtai Central Hospital from August 2020 to May 2024 were selected as the study objects.They were divided into an experimental group and a control group by central randomization method,with 58 cases in each group.The control group was treated with insulin aspart injection,whereas the experimental group was treated with vitamin D combined with insulin aspart injection.The incidence of adverse maternal-infant outcomes in both groups was recorded.The differences in serum glucose metabolism-related indicators[homeostasis model assessment-β(HOMA-β),HbA1c,RBG-4],serum internal environment improvement-related indicators{calcitriol[1,25(OH)2D3],serum calcium},lipid metabolism-related indicators[adiponectin(APN),visfatin(VF)],and disease related biochemical indicators[lipoprotein-associated phospholipase A2(Lp-PLA2),vascular cell adhesion molecule-1(VCAM-1)]before treatment and after 1 month of treatment were compared.Results The incidence of adverse maternal-infant outcomes in the experimental group was lower than that in the control group,but the difference was not statistically significant(P>0.05).After 1 month of treatment,the HOMA-β,APN,1,25(OH)2D3 and serum calcium levels in both groups were higher than those before treatment,and the above indicators in the experimental were higher than those in the control group(P<0.05).The levels of HbA1c,RBG-4,VF,Lp-PLA2 and VCAM-1 in both groups were lower than those before treatment,and the above indicators in the experimental were lower than those in the control group(P<0.05).Conclusion The combination of insulin aspart injection and vitamin D has a good clinical effect on pregnant women with GDM,which can enhance the glucolipid metabolism of pregnant women,promote the recovery of isletβcell function,alleviate the insulin resistance,and improve the adverse maternal-infant outcomes.
作者
董珊珊
刘循灿
程飞飞
申晓娜
冷慧敏
Dong Shanshan;Liu Xuncan;Cheng Feifei;Shen Xiaona;Leng Huimin(Department of Obstetrics,Xingtai Central Hospital,Xingtai 054000,China;Delivery Room,Xingtai Central Hospital,Xingtai 054000,China;Department of Obstetrics,Qinhuangdao Haigang Hospital,Qinhuangdao 066200,China)
出处
《成都医学院学报》
2025年第1期98-101,共4页
Journal of Chengdu Medical College
基金
河北省卫生健康委员会医学科学研究课题(No:20221624)。
关键词
门冬胰岛素
维生素D
妊娠期
糖尿病
糖代谢
脂代谢
Insulin aspart
Vitamin D
Gestational
Diabetes mellitus
Glucose metabolism
Lipid metabolism
