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目的:评价格列本脲(优降糖)对比胰岛素在治疗妊娠期糖尿病的安全性及疗效。方法:以妊娠期/孕期糖尿病、口服降糖药、格列本脲、优降糖为检索词,检索conhrence图书馆(2010年第3期)、MEDLIN(pubmed 1980～2011年)、EMBASE(1984～2011年)、中国生物医学文献光盘数据库(1978～2011年)、中文期刊全文数据库(1979～2011年)的文献,手工检索相关文献,要求为临床随机对照试验,评价文献质量。数据分析采用Stata 11.0,对于异质性小的研究合并效应量。结果:纳入4个随机对照试验,共577个受试对象。结果表明格列本脲与胰岛素对比在控制血糖上同样有效,且对胎儿的生长发育无不良反应。但是在新生儿体重、巨大儿发生率及新生儿低血糖发生率等方面两者有差异。结论:格列本脲在控制血糖效果上和胰岛素无差异且使用安全,但是对新生儿、巨大儿及新生儿低血糖发生率的影响仍不能优于胰岛素。
Objective: To evaluate the safety and efficacy of glyburide (glyburide) versus insulin in the treatment of gestational diabetes mellitus (DM). METHODS: The conhrence library (Issue 3, 2010), MEDLIN (pubmed 1980-2011), EMBASE (1984) were searched using the term of pregnancy / gestational diabetes mellitus, oral hypoglycemic agents, glyburide and glyburide ~ 2011), Chinese Biomedical Literature CD-ROM Database (1978-2011) and Chinese Journal Full-text Database (1979-2011), and hand searched related literatures. It is required to be a clinical randomized controlled trial to evaluate the quality of the literature. Data analysis using Stata 11.0, for heterogeneity of the study combined effect amount. RESULTS: Four randomized controlled trials were included, with a total of 577 subjects. The results show that glyburide and insulin contrast in the control of blood sugar equally effective, and fetal growth and development without adverse reactions. However, there are differences in the weight of newborns, the incidence of macrosomia and the incidence of neonatal hypoglycemia. CONCLUSIONS: Glibenclamide is indistinguishable from insulin in controlling blood glucose levels and is safe to use, but its effect on neonates, macrosomia, and neonatal hypoglycaemia still does not outweigh the effects of insulin.