二甲双胍和格列苯脲在妊娠期糖尿病中的安全性和有效性评价：网络Meta分析

发布时间：2018-11-19 08:07

【摘要】：目的：通过与胰岛素比较，分析二甲双胍和格列苯脲在妊娠期糖尿病（Gestational Diabetes Mellitus, GDM）中的安全性和有效性；方法：系统性检索PubMed, EMBASE, the Cochrane Central Register ofControlled Trials (CENTRAL)，和中国生物医学生物文献数据库，截至2013年12月有16篇随机对照试验包含二甲双胍及格列苯脲与胰岛素的比较。主要结果：本研究有2665例病例纳入。在巨大儿方面，格列苯脲组多于胰岛素组(OR=3.299,95%CI=1.649to6.600, P=0.001），而二甲双胍组低于格列苯脲组(OR=0.234，95%CI=0.061to0.893，P=0.033)，二甲双胍组与胰岛素组无显著差异（P=0.198）。在孕妇体重增加方面，二甲双胍组明显低于胰岛素组（SMD=-0.539，95%CI=-0.716to-0.362，P=0.000）。妊娠时限方面，二甲双胍明显短于胰岛素组（SMD=-0.142，95%CI=-0.246to-0.039，P=0.007）。结论：二甲双胍控制血糖的疗效好，，母亲体重增加少，有更低的糖化血红蛋白水平，且不增加母亲低血糖风险，但可能增加早产风险。格列苯脲组有更高的巨大儿发生率。
[Abstract]:Objective: to analyze the safety and efficacy of metformin and glibenclamide in gestational diabetes mellitus (Gestational Diabetes Mellitus, GDM) by comparing with insulin. Methods: PubMed, EMBASE, the Cochrane Central Register ofControlled Trials (CENTRAL), and Chinese biomedical literature database were systematically searched. As of December 2013, 16 randomized controlled trials included metformin, glibenclamide and insulin. Main results: 2665 cases were included in this study. In macrosomia, glibenclamide group was more than insulin group (OR=3.299,95%CI=1.649to6.600, P0. 001), while metformin group was lower than glibenclamide group (OR=0.234,95%CI=0.061to0.893,P=0.033). There was no significant difference between metformin group and insulin group (P = 0.198). In weight gain, metformin group was significantly lower than insulin group (SMD=-0.539,95%CI=-0.716to-0.362,P=0.000). In pregnancy duration, metformin was significantly shorter than insulin group (SMD=-0.142,95%CI=-0.246to-0.039,P=0.007). Conclusion: metformin has a good effect on blood glucose control. Mothers have less weight gain, lower glycosylated hemoglobin level and less risk of hypoglycemia, but may increase the risk of premature delivery. The glibenclamide group had a higher incidence of macrosomia.
【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R587.1

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