【摘要】 目的:探究精蛋白锌重组人胰岛素联合门冬胰岛素治疗妊娠期糖尿病的疗效及其对同型半胱氨酸(Hcy)、肿瘤坏死因子(TNF-α)、白细胞介素-6(IL-6)、C反应蛋白(CRP)的影响。方法:选取本院妇产科2018年8月～2019年11月收治的80例妊娠期糖尿病患者,按照随机数字表法分为研究组和对照组,每组40例。对照组给予门冬胰岛素治疗,研究组在对照组的基础上给予精蛋白锌重组人胰岛素治疗妊娠期糖尿病患者。观察并比较两组治疗总有效率、治疗前后血糖水平变化[糖化血红蛋白(GHb)、空腹血糖(FBG)、餐后2 h血糖(2hPG)]、血清胱抑素C(CysC)及Hcy水平、细胞炎性因子水平(TNF-α、IL-6、CRP)及产妇、新生儿并发症发生情况。结果:研究组治疗总有效率(90.00%)高于对照组(67.50%,P <0.05);治疗前两组血清中TNF-α、IL-6、CRP、CysC、Hcy、GHb、FBG、2hPG水平比较,无统计学差异(P> 0.05);治疗后两组血清TNF-α、IL-6、CRP、CysC、Hcy、GHb、FBG、2hPG水平较治疗前均降低(P <0.05),且研究组低于对照组(P <0.05);研究组产妇及新生儿并发症发生率(15.00%和12.50%)低于对照组(37.50%和40.00%,P <0.05)。结论:精蛋白锌重组人胰岛素联合门冬胰岛素治疗妊娠糖尿病效果良好,可有效控制患者血糖水平、调节血清炎性因子水平、降低CysC和Hcy水平、降低产妇及新生儿并发症发生率,且安全有效。更多还原

【Abstract】 Objective: To investigate the therapeutic effect of mixed protamine zinc recombinant human insulin injection with insulin aspart on gestational diabetes mellitus and its influences on homocysteine( Hcy),tumor necrosis factor( TNF-α),interleukin-6( IL-6) and C-reactive protein( CRP).Methods: A total of 80 patients with gestational diabetes admitted in the Obstetrics and Gynecology department of our hospital from August2018 to November 2019 were randomly divided into study group and control group,with 40 cases in each group.The control group was treated with insulin aspart,and the study group was treated with additional mixed protamine zinc recombinant human insulin injection on the basis of the control group.The total effective rate,the changes of blood glucose [glycosylated hemoglobin( GHb),fasting blood glucose( FBG),blood glucose after 2 h( 2 hPG) ],serum cystatin C( CysC),Hcy,cell inflammatory factors( TNF-α,IL-6,CRP) levels and the complications of maternity and newborn were observed and compared.Results: The total effective rate of 90.00% in the study group was significantly higher than 67.50% in the control group( P < 0.05).There was no significant difference in serum TNF-α,IL-6,CRP,Cys C,Hcy,GHb,FBG and 2 hPG levels between the two groups before treatment( P > 0.05).The levels of TNF-α,IL-6,CRP,Cys C,Hcy,GHb,FBG and 2 hPG in the two groups after treatment were significantly lower than those before treatment( P < 0.05),and those in the study group were significantly lower than those in the control group( P < 0.05).The incidences of maternal and neonatal complications in the study group were15.00% and 12.50% respectively,which were significantly lower than 37.50% and 40.00% in the control group( P < 0.05).Conclusion: Mixed protamine zinc recombinant human insulin injection combined with insulin aspart is effective in the treatment of gestational diabetes mellitus.It can effectively control the blood glucose level,regulate the levels of serum inflammatory factors,and reduce the levels of CysC and Hcy,and with low incidences of complications in pregnant women and neonates,which is safe and effective.更多还原