目的评估动态血糖监测系统在妊娠期糖尿病治疗过程中低血糖发生的防治作用。方法计算机检索Pub Med、MEDLINE、Cochrane Database of Systematic Reviews、EMbase、CNKI、万方数据库和维普科技期刊全文数据库中关于连续动态血糖监测系统在妊娠期糖尿病诊疗中应用的相关研究,同时也追索相关临床在研数据库和纳入文献中的参考文献,全面扩大检索范围,保证本次检索的查全率。检索时限均为建库至2014年9月19日。按照纳入标准、剔除标准由两名数据评价员分别进行文献筛选、数据提取和质量评价,并对纳入文献中的数据进行meta分析。分析软件为Rev Man 5.2。结果共纳入7篇文献,共765例妊娠期糖尿病孕产妇。Meta分析结果显示:在妊娠期糖尿病诊疗过程中,动态血糖监测系统(Continuous Glucose Monitoring System,CGMS)和常规血糖监测相比,其突出优势为可提供全天、连续、全面、可靠的血糖信息,为临床用药及制定个性化诊疗方案提供有力依据。采用CGMS系统诊疗的妊娠期糖尿病孕产妇在诊治过程中出现低血糖的频率较常规血糖监测少,OR值为0.17,95%CI为(0.09⁰.31),P<0.01。结论动态血糖监测系统的应用可降低低血糖事件的发生。

Objective To evaluate the clinical effects of continuous glucose monitoring system( CGMS) on prevention of the occurrence of hypoglycemia in patients with gestational diabetes mellitus( GDM). Methods This is a case control study involving cases about the application of CGMS on gestational diabetes mellitus to reduce the incidence of the hypoglycemia. The correlational studies were searched from the earliest date through September 2014 from Pub Med,Medline,Cochrane Database of Systematic Reviews,EMbase,CNKI,WANFANG database,VIP science and technology journal full-text database. Two reviewers independently screened literatures,extracted data and further assessed the quality of the data according to the inclusion and exclusion criteria. Metaanalysis was performed using Rev Man 5. 2 software. Results 7 studies involving 765 GDM patients were finally recruited. Our metaanalysis results showed that the incidence of the hypoglycemia in GDM patients monitored with CGMS was significantly lower than that in GDM patients monitored with Regular blood glucose monitoring( OR = 0. 17,95% CI( 0. 09- 0. 31),P < 0. 01). In the process of the treatment of GDM,the clinical effects were obvious better in GDM patients monitored with CGMS than those in GDM patients monitored with Regular blood glucose monitoring. The outstanding advantages of CGMS were to provide available,continuous,comprehensive reliable information on blood sugar all day,which can effectively guide the adjustment and efficacy assessment of the clinical dose,and prevent the occurrence of hypoglycemia events. Conclusion The application of CGMS on GDM has the potential to reduce the incidence of the hypoglycemia.