摘要
目的研究糖尿病患者孕期胰岛素的应用特点. 方法回顾性分析1981年1月至2003年12月116例糖尿病合并妊娠妇女的治疗情况.116例患者中共有95例在孕期使用胰岛素治疗,其中妊娠36周以后开始治疗者3例;28周以前终止妊娠者7例;胰岛素剂量不详者2例;治疗过程中胎死宫内者1例,其余82例作为观察对象,研究其孕期胰岛素应用特点. 结果 82例孕妇中18例孕期行口服葡萄糖耐量试验,其各点血糖值明显异常,均已达到非孕期糖尿病诊断标准;孕期胰岛素用量随孕周增加而逐渐增加,孕32～36周达高峰,孕36周后略下降直至分娩;孕前未用胰岛素者胰岛素用量增加明显.使用动物胰岛素用量≥100 IU的孕妇的体重指数(BMI)明显高于胰岛素用量＜100 IU的孕妇(P=0.006). 结论 (1)妊娠期胰岛素用量随孕周增加而变化.(2)动物胰岛素易产生胰岛素抵抗,建议孕期应用人胰岛素.
Objective To investigate the characteristics of insulin requirements during pregnancy in women with pre-gestational diabetes mellitus. Methods A retrospective study was conducted on 116 pregnant women with pre-gestational diabetes admitted to the Department of Obstetrics ＆ Gynaecology, First Hospital, Peking University from 1981 to 2003. Ninty-five among the 116 cases required insulin during pregnancy among which 82 cases were enrolled in the observational group. Resuits Eighteen women in the observational group had OGTT performed during pregnancy whose values were above the diagnostic criteria of non-pregnant diabetes. The insulin requirements increased with the gestational age with the peak dose at 32-36 weeks followed by slight decrease till delivery. Among all the women who used animal insulin, the average BMI of those whose dose 〈100 IU was higher than those ≥100 IU. Conclusions The insulin requirements during pregnancy vary according to the gestational weeks. Reduced insulin requirements during the third trimester might be associated with the increase of glucose utilization in fetus, but not the failure of placental function, thus the pregnancy is allowed to be continued provided strict fetal monitoring available. Human insulin product is better than those made from animal because of less resistance.
出处
《中华围产医学杂志》
CAS
2005年第5期296-299,共4页
Chinese Journal of Perinatal Medicine
