摘要
目的探究利拉鲁肽对2型糖尿病(T2DM)合并非酒精性脂肪性肝病(NAFLD)患者肝酶指标、抗氧化水平及血清肝纤维化指标的影响。方法选取2018-08-13-2020-12-15济源职业技术学院附属医院T2DM合并NAFLD患者115例作为研究对象,依据治疗药物不同分为对照组和观察组。对照组57例采用多烯磷脂酰胆碱胶囊治疗,观察组58例在对照组基础上联合利拉鲁肽注射液皮下注射治疗,对比2组患者肝酶活性,抗氧化反应能力,血清肝纤维化指标,不良反应。结果观察组治疗3个月丙氨酸氨基转移酶(ALT)(52.64±10.53)U/L、天门冬氨酸氨基转移酶(AST)(62.38±12.13)U/L、谷氨酰转肽酶(GGT)(96.03±15.24)U/L与对照组(81.12±14.21)U/L、(94.32±18.67)U/L、(128.42±19.81)U/L比较,差异有统计学意义,F值分别为441.807、364.214和241.811,均P<0.001;观察组治疗3个月总胆红素(TBIL)(18.56±2.67)μmol/L与对照组(18.61±2.73)μmol/L比较,差异无统计学意义,F=0.015,P=0.902。观察组治疗3个月总抗氧化能力(T-AOC)(39.02±5.12)U/mL、超氧化物歧化酶(SOD)(87.92±11.56)μg/mL、丙二醛(MDA)(8.61±1.05)ng/mL、一氧化氮(NO)(12.46±1.72)mg/L与对照组(26.13±3.25)U/mL、(64.03±6.87)μg/mL、(12.15±1.21)ng/mL、(20.13±2.11)mg/L比较,差异有统计学意义,F值分别为532.617、499.880、696.451和930.971,均P<0.001。观察组治疗3个月透明质酸(HA)(70.22±9.15)ng/mL、层粘连蛋白(LN)(96.23±8.14)ng/mL、Ⅳ型胶原(CⅣ)(50.16±0.75)ng/mL、Ⅲ型前胶原(PⅢP)(6.15±0.64)ng/mL与对照组(87.63±10.12)ng/mL、(105.32±9.42)ng/mL、(65.42±0.93)ng/mL、(8.26±0.72)ng/mL比较,差异有统计学意义,F值分别为266.672、77.242、11601.871和435.115,均P<0.001。观察组不良反应发生率6.90%(4/58)高于对照组的3.51%(2/57),差异无统计学意义,χ^(2)=0.158,P=0.691。结论利拉鲁肽治疗T2DM合并NAFLD患者,可调节肝纤维化指标,改善肝酶活性,调控抗氧化反应能力,有较高安全性,提高临床疗效。
Objective To investigate the effects of liiraglutide on liver enzyme indexes,antioxidant levels and serum liver fibrosis indexes in type 2 diabetes mellitus(T2DM)patients complicated with non-alcoholic fatty liver disease(NAFLD).Methods A total of 115 T2DM patients complicated with NAFLD in Affiliated Hospital of Jiyuan vocational and technical institute from August 132018 to December 15,2020 were selected as the research objects,and divided into control group and observation group according to different treatment drugs.Fifty-seven patients in the control group were treated with polyene phosphatidylcholine capsule,and 58 patients in the observation group were treated with liraglutide injection subcutaneously on the basis of the control group.Liver enzyme activities,antioxidant capacity,serum liver fibrosis indicators and adverse reactions were compared between the two groups.Results There is significant difference in alanine aminotransferase(ALT)(52.64±10.53)U/L,aspartate aminotransferase(AST)(62.38±12.13)U/L,glutamyltransferase(GGT)(96.03±15.24)U/L of observation group within 3 months after treatment,compared with those in the control group(81.12±14.21)U/L,(94.32±18.67)U/L and(128.42±19.81)U/L(F=441.807,364.214,241.811,all P<0.001).There was no significant difference in total bilirubin(TBIL)between the observation group(18.56±2.67)μmol/L and the control group(18.61±2.73)μmol/L after 3months of treatment(F=0.015,P=0.902).The total antioxidant capacity(T-AOC)(39.02±5.12)U/mL,SOD(87.92±11.56)μg/mL,MALondialdehyde(MDA)(8.61±1.05)ng/mL,nitric oxide(NO)(12.46±1.72)mg/L of observation group after 3months of treatment were significantly higher than those of control group(26.13±3.25)U/mL,(64.03±6.87)μg/mL,(12.15±1.21)ng/mL,(20.13±2.11)mg/L,and the difference was statistically significance(F=532.617,499.880,696.451,930.971,All P<0.001).The hyaluronic acid(HA)(70.22±9.15)ng/mL,laminin(96.23±8.14)ng/mL,typeⅣcollagen(CⅣ)(50.16±0.75)ng/mL,typeⅢprocollagen(PⅢP)(6.15±0.64)ng/mL in the observation
作者
焦彦林
吕亚林
周羽
JIAO Yan-lin;LYU Ya-lin;ZHOU Yu(Department of internal medicine,Affiliated Hospital of Jiyuan vocational and technical institute,Jiyuan 459000,China)
出处
《社区医学杂志》
CAS
2022年第9期495-499,共5页
Journal Of Community Medicine
