格列苯脲联合门冬胰岛素治疗妊娠糖尿病及对患者 Irisin 和人源甘丙肽水平表达的影响

Effect of Glibenclamide combined with Insulin aspartate on levels of irisin and galanin in patients with gestational diabetes mellitus

摘要:

目的??探索格列本脲联合门冬胰岛素治疗妊娠期糖尿病（GDM）及其对患者血清 Irisin 及人源甘 丙肽（GAL）的影响。方法??选取 2016 年 2 月 -2017 年 2 月海南省人民医院收治的 100 例妊娠期糖尿病患者 为观察对象，将其按照随机数字表法分为对照组和观察组，每组 50 例。对照组应用门冬胰岛素治疗，观察组 应用格列本脲联合门冬胰岛素治疗，对比两组患者入组时及治疗后的糖代谢指标﹑血清胱抑素 C（Cys?C）﹑同 型半胱氨酸（Hcy）﹑ Irisin 及 GAL 水平，治疗过程中不良反应的发生情况。结果??治疗后，两组患者空腹血糖 （FPG） 、餐后 1?h 血糖（1?hPG） 、餐后 2?h 血糖（2?hPG）及糖化血红蛋白（HbAlc）水平均下降（ P ?<0.05） ，观 察组上述指标水平均低于对照组（ P ?<0.05） ； 治疗后， 两组血清 Cys?C 与 Hcy 均降低（ P ?<0.05） ， 与对照组比较， 观察组 Cys?C 与 Hcy 水平更低（ P ?<0.05） ； 治疗后， 两组血清 Irisin 升高而 GAL 降低（ P ?<0.05） ， 观察组 Irisin 及 GAL 变化程度优于对照组（ P ?<0.05） ； 两组妊娠高血压征、胎膜早破、产程延长、羊水过多发生率的差异无 统计学意义（ P ?>0.05） ， 观察组低血糖及早产儿发生率低于对照组（ P ?<0.05） 。结论??格列本脲联合门冬胰岛素有 助于 GDM 患者的血糖控制，可通过降低血清 Cys?C ﹑ Hcy ﹑ GAL，升高血清 Irisin 水平来改善胰岛素抵抗，安全可靠， 值得推广。

Abstract:

Objective To explore the effect of Glibenclamide combined with Insulin aspartate on the serum levels of irisin and galanin (GAL) in patients with gestational diabetes mellitus. Methods A total of 100 cases of gestational diabetes mellitus treated in Hainan General Hospital from February 2016 to February 2017 were selected as the observation subjects. They were divided into the control group and the observation group according to the random number table method, 50 cases in each group. The control group was treated with Insulin aspartate, and the observation group was treated with Glibenclamide and Insulin aspartate, the glycometabolism indexes, serum Cystatin C (Cys C), homocystein (Hcy), Irisin and GAL levels were compared pre- and post-treatment. The occurrence of adverse reactions during treatment were also compared. Results After treatment, the levels of fasting blood-glucose (FPG), postprandial 1 h blood glucose (1 hPG), postprandial 2 h blood glucose (2 hPG) and hemoglobin Alc (HbA1c) levels decreased in the two groups (P < 0.05), which were lower in the observation group than in the control group. After treatment, the serum Cys C and Hcy of the two groups were decreased (P < 0.05), the Cys C and Hcy levels of the observation group were lower than that of the control group. After treatment, serum Irisin increased and GAL decreased (P < 0.05), the changes of Irisin and GAL in the observation group were better than those in the control group (P < 0.05). There was no significant difference in the incidence of gestational hypertension, premature rupture of fetal membranes, prolonged labor and hydramnion in the two groups (P > 0.05). The incidence of hypoglycemia and preterm infants in the observation group was lower than that in the control group (P < 0.05). Conclusions Glibenclamide combined with Insulin aspartate is helpful for glycemic control in GDM patients. It can improve insulin resistance by lowering serum Cys C, Hcy, GAL and increasing serum Irisin levels, which is safe and reliable and worth promoting.