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门冬胰岛素与生物合成人胰岛素注射液治疗妊娠期糖尿病的效果观察

Effect of novorapid and novolin R in the treatment of patients with gestational diabetes

摘要:

目的 探究对比门冬胰岛素(诺和锐)与生物合成人胰岛素注射液(诺和灵R)治疗妊娠期糖尿病患者的有效性和安全性.方法 回顾性分析2014年9月至2015年10月在峨眉山市人民医院接受治疗的妊娠期糖尿病患者58例,根据患者所用药物将其分为两组,对照组给予诺和灵R治疗,观察组给予诺和锐治疗.对比两组治疗后的总有效率、空腹血糖(FBG)、餐后2 h血糖(2 h PBG)、平均血糖达标时间、体质量指数(BMI)、肝肾功能谷丙转氨酶(ALT)、谷草转氨酶(AST)、血肌酐(SCr)、尿素氮(BUN)变化及低血糖发生次数、胰岛素用量、妊娠结局.结果 治疗后,观察组FBG(5.14±0.39)mmol/L、2 h PBG(7.06±1.25)mmol/L均明显低于对照组(t=11.72、5.67;P<0.05);ALT(25.27±8.71)U/L,AST(27.98±8.53)U/L,SCr(69.92±11.39)μmol/L,BUN(5.23±5.75)mmol/L,与对照组差异均无统计学意义(t=0.14、0.07、0.04、0.30,均P>0.05);总有效率93.10%、平均血糖达标时间(3.06±0.43)d、胰岛素用量(36.15±4.72)U/d,均明显优于对照组(χ2=4.35,t=14.30、4.92,均P<0.05);妊娠高血压发生率3.45%、羊水过多发生率6.90%、剖宫产率17.24%、巨大儿发生率3.45%、高胆红素血症发生率3.45%,均明显低于对照组(χ2=5.22、5.50、4.08、9.09、7.73,均P<0.05);体质量(70.6±3.09)kg,BMI(23.9±0.28)kg/m2,均明显优于对照组(t=2.20,12.19,均P<0.05);低血糖事件发生率(17.24%),明显低于对照组(χ2=5.47,P<0.05).结论 诺和锐较诺和灵R用于妊娠期糖尿病治疗的效果显著,且具有较高的安全性,值得临床进一步推广实施.

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abstracts:

Objective To compare the efficacy and safety of novorapid and novolin R in the treatment of patients with gestational diabetes.Methods From September 2014 to October 2015,the clinical data of 58 patients with gestational diabetes in our hospital were retrospectively analyzed.According to the drug used,the patients were divided into two groups.The observation group was given novorapid,and the control group was given novolin R.Before and after treatment,the total effective rate,fasting blood glucose (FBG),2h postprandial blood glucose (2hPBG),average blood glucose control time,body mass index (BMI),alanine transaminase (ALT),aspartate aminotransferase (AST),serum creatinine (SCr),urea nitrogen (BUN) and the frequency of hypoglycaemia,insulin dosage,the pregnancy outcome were compared between the two groups.Results After treatment,the FBG [(5.14±0.39)mmol/L],2hPBG[(7.06±1.25)mmol/L] of the observation group were significantly lower than those of the control group (t=11.72,5.67,all P<0.05).ALT[(25.27±8.71)U/L],AST[(27.98±8.53)U/L],SCr[(69.92±11.39)μmol/L],BUN[(5.23±5.75)mmol/L] of the observation group had no obvious differences compared with the control group (t=0.14,0.07,0.04,0.30,all P>0.05).The total effective rate (93.10%),average blood glucose control time (3.06±0.43)d,insulin dosage (36.15±4.72)U/d of the observation group were significantly better than those of the control group (χ2=4.35,t=14.30,4.92,all P<0.05).The incidence rates of pregnancy-induced hypertension (3.45%),amniotic fluid (6.90%),cesarean delivery (17.24%),macrosomia(3.45%),high blood bilirubin(3.45%) of the observation group were significantly lower than those of the control group(χ2=5.22,5.50,4.08,9.09,7.73,all P<0.05).Body weight [(70.6±3.09)g],BMI[(23.9±0.28)kg/m2] of the observation group were better than those of the control group(t=2.20,12.19,all P<0.05).The incidence rate of hypoglycemic events in observation group(17.24%) was significantly lower than that of the control group(χ2=5.47,P<0.05).Conclusion Compare with novolin R,the treatment effect of novorapid for gestational diabetes is remarkable and has high security,it is worthy of clinical implementation.

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