益生菌补充剂联合门冬胰岛素对妊娠期糖尿病患者肠道菌群和母婴结局的影响

The impact of probiotic supplements combined with insulin aspart on gut microbiota and maternal-infant outcomes in patients with gestational diabetes mellitus

摘要:

目的 探讨益生菌补充剂联合门冬胰岛素对妊娠期糖尿病患者肠道菌群和母婴结局的影响。方法 选取2020年4月—2023年4月成都市第七人民医院就诊的104例妊娠期糖尿病患者作为研究对象。通过随机数字表法将患者分为对照组（给予门冬胰岛素）和联合组（对照组基础上增加益生菌补充剂），每组52例。比较两组治疗前后糖代谢指标、脐血流阻力、肠道菌群结构、母婴结局以及不良反应发生率。结果 联合组治疗前后空腹血糖、餐后2 h血糖、糖化血红蛋白、胰岛素抵抗指数的差值均高于对照组（P <0.05）。联合组治疗前后脉搏指数、阻力指数、收缩期/舒张期比值的差值均高于对照组（P <0.05）。联合组治疗前后乳酸杆菌、双歧杆菌数量的差值均高于对照组，大肠杆菌差值的差值低于对照组（P <0.05）。联合组总不良妊娠率、不良新生儿率均低于对照组（P <0.05）。两组总不良反应发生率比较，差异无统计学意义（P >0.05）。结论 益生菌补充剂联合门冬胰岛素的治疗方案能有效改善妊娠期糖尿病患者的肠道菌群状况，优化血糖控制，从而改善母婴结局，治疗过程安全，值得临床推广应用。

Abstract:

Objective To investigate the impact of probiotic supplements combined with insulin aspart on the gut microbiota and maternal-infant outcomes in patients with gestational diabetes mellitus.Methods Between April 2020 and April 2023, a total of 104 patients with gestational diabetes mellitus treated in Chengdu Seventh People's Hospital were selected for this study. By using the random number table method, the patients were divided into a control group (treated with insulin aspart) and a combination group (treated with probiotic supplements in addition to insulin aspart), with 52 cases in each group. The indicators of glucose metabolism, resistance to umbilical blood flow, and gut microbiota structures before and after the treatment as well as maternal-infant outcomes and the incidence of adverse reactions were compared between the two groups.Results The differences in levels of fasting blood glucose, 2-h postprandial blood glucose, glycated hemoglobin, and insulin resistance index (HOMA-IR) before and after the treatment in the combination group were greater than those in the control group (P < 0.05). The differences in the pulsatility index, resistive index, and the systolic / diastolic ratio before and after the treatment in the combination group were greater than those in the control group (P < 0.05). Besides, the differences in the frequencies of Lactobacillus, Bifidobacterium, and Escherichia coli before and after the treatment in the combination group were also greater than those in the control group (P < 0.05). The overall incidence of adverse pregnancy outcomes and neonatal outcomes in the combination group was lower than that in the control group (P < 0.05). The overall incidence of adverse reactions did not differ significantly between the two groups (P > 0.05).Conclusions The treatment regimen combining probiotic supplements with insulin aspart can effectively improve the gut microbiota homeostasis and optimize glycemic control in patients with gestational diabetes mellitus, and thereby contribute to better maternal-infant outcomes. The treatment is safe and worthy of being widely applied in clinical practice.