Abstract

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≥100 IU的孕妇的体重指数(BMI)明显高于胰岛素用量<100 IU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。

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