摘要
目的在使用二甲双胍的前提下,探讨厄贝沙坦联合α-硫辛酸对2型糖尿病合并非酒精性脂肪肝（NAFLD）患者胰岛素抵抗相关指标的影响。方法将112例2型糖尿病合并NAFLD患者随机分为对照组和观察组,均进行健康教育,对照组给予二甲双胍500 mg起始剂量进行药物干预,观察组在对照组治疗基础上给予厄贝沙坦＋α-硫辛酸干预。其中厄贝沙坦150 mg口服,每日一次;α-硫辛酸600 mg,每日一次,静滴2~3周,出院后改为口服制剂序贯治疗,600 mg,每日一次。均治疗8周。治疗前后观察患者空腹血糖、餐后2 h血糖、糖化血红蛋白（HBA1c）、C肽、瘦素、内脏脂肪素、胰岛素、胰岛素抵抗指数（IRI）、血压和血脂等的变化。结果较治疗前相比,治疗后所有患者空腹血糖和餐后2 h血糖较治疗前明显下降（P〈0.05）,观察组较对照组下降明显（P〈0.05）;治疗后两组患者HBA1c有下降趋势,但却未见显著差异（P〉0.05）;两组C肽逐渐下降,与治疗前相比差异显著（P〈0.05）,且组间具有显著差异（P〈0.05）;治疗后受试患者胰岛素、IRI以及瘦素、内脏脂肪素水平均明显降低（P〈0.05）,且观察组较上述指标下降更为明显;治疗后两组三酰甘油和总胆固醇均下降（P〈0.05）,但组间无明显差异（P〉0.05）,血压下降均在正常范围内。结论在二甲双胍降糖治疗基础上,厄贝沙坦联合α-硫辛酸较单用二甲双胍方案能改善胰岛素抵抗效应,明显地抑制机体瘦素和内脏脂肪素的分泌,且安全及耐受性较佳。
AIM To detect the effect of irbesartan joining with α- lipoic acid for related indexes of patients with both type 2 diabetes and non- alcoholic fatty liver disease（ NAFLD） under the premise of using metformin. METHODS One hundred and twelve patients with both type 2 diabetes and NAFLD were randomly divided into control group and observation group. The control group was given health education and metformin treatment（ 500 mg starting dose）. The observation group was added both irbesartan and α- lipoic acid,irbesartan was given orally at dose of 150 mg, qd, α- lipoic acid was given 600 mg intravenous infusion, qd,continuously 2- 3 weeks, oral preparation sequential therapy was used after discharge, 600 mg, qd, with a treatment course of 8 weeks. Fasting blood glucose（ FBG）, 2- hour postprandial blood glucose（ 2h PG）,glycosylation hemoglobin hemoglobin A1c（HBA1c） and C peptide as well as BP and lipids were evaluated before and after the treatment, the level of leptin, visfatin and insulin resistance index（ IRI） were detected and calculated at the same times. RESULTS After 8 weeks treatment, FBG and 2h PG were significantly lower than those before the treatment（P〈0.05）; the reduction of observation group was higher than control group（P〈0.05）. Glycosylation hemoglobin HBA1 cin two groups had a downward trend after the treatment, but had no statistical differences（ P〈0.05）; C peptide in two groups decreased gradually, and the difference was significant（ P〈0.05）, and there were significant differences between two groups（ P〈0.05）. Patients after treatment, IRI, leptin as well as insulin visfatin levels were significantly lower than before（P〈0.05）, and the index above in the observation group fell more obviously compared with the control group. Blood lipid（ triglyceride and total cholesterol） all decreased after treatment（ P〈0.05）, but there were no significant differences between two groups（ P〈0.05）. Blood pressure drops in the both groups were
出处
《中国新药与临床杂志》
CAS
CSCD
北大核心
2014年第10期765-769,共5页
Chinese Journal of New Drugs and Clinical Remedies
关键词
厄贝沙坦
硫辛酸
二甲双胍
糖尿病
2型
脂肪肝
瘦素
irbesartan thioctic acid metformin diabetes mellitus type 2 fatty liver leptin
