摘要
【目的】探讨二甲双胍联合利拉鲁肽治疗对2型糖尿病（type2diabetes mellitus，T2DM）合并非酒精性脂肪肝（nonalicoholie fatty liver disease，NAFLD）患者胰岛B细胞功能、肝功能及外周血Treg细胞的影响。【方法】选择2015年1月至2016年12月在本院诊治的T2DM合并NAFI．D患者93例，随机分为观察组（n=47）和对照组（n=46）。两组患者均口服二甲双胍，观察组同时给予利拉鲁肽皮下注射，对照组患者同时给予甘精胰岛素皮下注射，疗程为3个月。比较两组治疗前、后糖化血红蛋白（HbA1c）、空腹血糖（FPG）、餐后2小时血糖（2hPG）、空腹胰岛素（FINS）水平、胰岛素抵抗指数（HOMA—IR）、D细胞功能指数（HOMA—p）、血清谷丙转氨酶（ALT）、血清谷草转氨酶（AST）、血清7谷氨酰转肽酶（GGT）、血清总胆固醇（TC）、三酰甘油（TG）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）水平及外周血Treg细胞占CD4＋T细胞比例。【结果】与治疗前比较，两组患者治疗后HbAle、FPG、2hPG水平、HOMA—IR值均降低（P〈0．05），HOMA-8值升高（P〈0．05）；观察组治疗后HbA1c水平低于对照组，且差异具有统计学意义（t=2．230，P=0．028），其余指标比较差异无统计学意义（P〉0．05）。两组患者治疗前肝功能和脂代谢指标比较差异均无统计学意义（P〉0．05）；观察组患者治疗后肝功能指标ALT、AST及GGT水平与治疗前比较均下降，其差异均有统计学意义（P〈0．05），而对照组患者ALT、AST及GGT水平与治疗前比较差异无统计学意义（P〉0．05）；两组脂代谢指标TC、TG、HDL—C及LDL—C水平较治疗前均下降，差异均具有统计学意义（P〈0．05），且观察组下降更显著（P〈0．05）。两组患者治疗前外周血Treg／CD4＋分别为（5．62±1．80）％、（5．74±1．53）％，两组比较差异无统计学意义�
[Objective]To investigate the effects of metformin combined with liraglutide on islet β cell function, liver function and Treg cells in peripheral blood of patients with type 2 diabetes mellitus （T2DM） and non-alcoholic fatty liver （NAFLD）.[MethodslFrom January 2015 to December 2016, 93 patients with T2DM complicated with NAFI.D were selected and were randomly divided into the observation group （ n = 47） and the control group （n = 46）. Two groups of patients were treated with metformin, the observation group received subcutaneous injection of liraglutide, the control group were given subcutaneous injection of insulin glargine. The course of treatment was 3 months. The levels of HbAlcN, FPGN, 2hPGN , FINS, HOMA-IR, HOMA-β, ALT, AST , GGT, TC, TG, HDL-C, LDITC, and the ratio of Treg cells in peripheral blood to CD4＋ T cells were compared between the two groups before and after treatment, the decrease in the observation group was more significant than that in the control group （ P 〈0.05）. The Treg/CD4＋ in peripheral blood of the two groups before treatment was 5.62 ±1.80 % and 5.74 ±1.53% respectively, there was no significant difference between the two groups （ P 〉0.05）.[Results]Compared with that before treatment, the level of HbAlc, FPG, 2hPG and HOMA-IR decreased after treatment in both groups （ P 〈 0.05） and the value of HOMA-βncreased significantly（ P 〈0.05）.The level of HbAlc in the observation was lower than that of the control group after treatment , the difference was significant（t = 2.230, P 〉0.028 ） , and the rest indexes has no statistical significance（ P 〉0.05）.There was no sig-nificant difference in liver function and lipid metabolism between the two groups before treatment （ P 〉0.05）. The levels of ALT, AST and GGT in the observation group were lower than those before treatment, and the difference was statistically significant （ P 〈0.05）. The levels of ALT, AST and C, GT in the control group were not significantly different from
出处
《医学临床研究》
CAS
2018年第1期11-14,共4页
Journal of Clinical Research
