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目的研究糖尿病患者孕期胰岛素的应用特点。方法回顾性分析1981年1月至2003年12月116例糖尿病合并妊娠妇女的治疗情况。116例患者中共有95例在孕期使用胰岛素治疗,其中妊娠36周以后开始治疗者3例;28周以前终止妊娠者7例;胰岛素剂量不详者2例;治疗过程中胎死宫内者1例,其余82例作为观察对象,研究其孕期胰岛素应用特点。结果82例孕妇中18例孕期行口服葡萄糖耐量试验,其各点血糖值明显异常,均已达到非孕期糖尿病诊断标准;孕期胰岛素用量随孕周增加而逐渐增加,孕32~36周达高峰,孕36周后略下降直至分娩;孕前未用胰岛素者胰岛素用量增加明显。使用动物胰岛素用量≥100I U的孕妇的体重指数(BMI)明显高于胰岛素用量<100I U的孕妇(P=0·006)。结论(1)妊娠期胰岛素用量随孕周增加而变化。(2)动物胰岛素易产生胰岛素抵抗,建议孕期应用人胰岛素。
Objective To study the characteristics of insulin during pregnancy in diabetic patients. Methods A retrospective analysis of 116 cases of diabetes between January 1981 to December 2003 treatment of pregnant women. A total of 116 patients with insulin in the treatment of 95 cases during pregnancy, including 36 weeks after pregnancy began treatment in 3 cases; 28 weeks before termination of pregnancy in 7 cases; insulin dose unknown in 2 cases; treatment of intrauterine fetal in 1 case , The remaining 82 cases as the object of observation to study the characteristics of insulin during pregnancy. Results In 82 pregnant women, 18 cases of oral glucose tolerance test during pregnancy, the abnormal blood glucose levels of each point, have reached the diagnostic criteria of non-pregnancy diabetes; insulin dosage during pregnancy increases with gestational age and gradually increased from 32 to 36 weeks of pregnancy reached its peak, 36 weeks after pregnancy decreased slightly until delivery; insulin before unused insulin increased significantly. The body mass index (BMI) of pregnant women who used animal insulin ≥ 100I U was significantly higher than that of pregnant women whose insulin dosage was less than 100IU (P = 0.006). Conclusion (1) The amount of insulin during pregnancy changes with gestational age. (2) animal insulin easy to produce insulin resistance, it is recommended to use human insulin during pregnancy.