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目的比较胰岛素泵与直接皮下注射胰岛素对妊娠糖尿病患者(gestational diabetes mellitus,GDM)疗效。方法选择妊娠糖尿病162例,分为胰岛素泵组与皮下注射胰岛素组(注射胰岛素组)。利用动态血糖监测系统(continuous glucose monito-ring system,CGMS)观察两组血糖、胰岛功能、血脂和生存质量分数,并对获得的数据进行统计分析。结果两组患者经治疗后,血糖相关指标、C肽、血脂均得到有效控制。但从两组对比可以看出,在C肽、HbA_1c(%)、空腹血糖(FPG)、餐后2h血糖(2h PG)、平均血糖波动幅度(mean amplitude of glycemic excursions,MAGE)、日间血糖平均绝对差(mean of daily differences,MODD)这些指标上,胰岛素泵组与注射胰岛素组比较,差异有统计学意义(P<0.05),且胰岛素泵组各指标的相对偏差都较注射胰岛素组小。在对血糖漂移率和低血糖发生率控制上,胰岛素泵组治疗效果明显好于注射胰岛素组(P<0.05),但是胰岛素泵组对高血糖率的控制更好。治疗后两组患者的生存质量比较,胰岛素泵组优于注射胰岛素组(P<0.05)。胰岛素泵组对患者的躯体健康和精神健康改善明显。结论与皮下注射胰岛素相比,胰岛素泵的疗效更好,且可使GDM患者血糖维持在比较理想的水平,减少对母婴的近期及远期危害。
Objective To compare the effects of insulin pump and direct subcutaneous injection of insulin on gestational diabetes mellitus (GDM). Methods 162 cases of gestational diabetes mellitus, divided into insulin pump group and subcutaneous insulin group (insulin injection group). Blood glucose, islet function, blood lipid and quality of life scores were observed by continuous glucose monito-ring system (CGMS), and the data were statistically analyzed. Results The two groups of patients after treatment, blood glucose-related indicators, C-peptide, blood lipids are effectively controlled. However, it can be seen from the comparison between the two groups that there is no significant difference in C peptide, HbA 1c (%), fasting blood glucose (FPG), 2h postprandial blood glucose (2h PG), mean amplitude of glycemic excursions (MAGE) Mean of daily differences (MODD) These indicators, the insulin pump group and injected insulin group, the difference was statistically significant (P <0.05), and the relative deviation of the insulin pump group than the insulin group injected small . Insulin pump treatment group was significantly better than insulin injection group (P <0.05) in control of blood glucose drift rate and incidence of hypoglycemia, but insulin pump group had better control of hyperglycemia. After treatment, the quality of life of the two groups of patients was better than that of insulin group (P <0.05). Insulin pump group on the patient’s physical and mental health improved significantly. Conclusion Compared with subcutaneous injection of insulin, insulin pump is more effective, and can maintain the blood glucose in GDM patients at an ideal level to reduce the immediate and long-term harm to mothers and children.