摘要
目的:探讨利格列汀对非酒精性脂肪性肝病(NAFLD)合并2型糖尿病患者血糖、胰岛功能及肝脏弹性测量值(LSM)的影响。方法:选取2019年1月至2020年4月苏州大学附属第二医院NAFLD合并2型糖尿病患者102例,根据治疗方式的不同将其分为研究组和对照组各51例,对照组给予二甲双胍治疗,研究组给予利格列汀联合二甲双胍治疗,观察比较两组治疗脂肪肝的效果,比较两组治疗前后空腹血糖(FBG)、糖化血红蛋白(HbA 1c)、稳态模型评估法胰岛素抵抗指数(HOMA-IR)、稳态模型评估法胰岛β细胞功能指数(HOMA-β)、丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、谷氨酰转肽酶(GGT)、LSM水平,记录两组治疗期间不良反应的发生情况。 结果:研究组脂肪肝的治疗总有效率明显高于对照组[96.1%(49/51)比82.4%(42/51)]( P<0.05);治疗后研究组FBG、HbA 1c、HOMA-IR、ALT、AST、GGT、LSM水平均明显低于对照组[(7.1 ± 1.0)mmol/L比(7.9 ± 0.9)mmol/L、(7.5 ± 0.7)%比(7.9 ± 1.0)%、3.2 ± 0.2比4.7 ± 0.3、(56.7 ± 10.4)U/L比(62.8 ± 8.2)U/L、(73.2 ± 6.8)U/L比(81.1 ± 6.7)U/L、(56.4 ± 10.2)U/L比(62.3 ± 8.1)U/L、(10.5 ± 3.3)kPa比(13.4 ± 1.6)kPa]( P<0.05),HOMA-β水平明显高于对照组(48.5 ± 8.3比41.2 ± 7.1)( P<0.05)。两组治疗期间不良反应发生率均较低,差异无统计学意义( P>0.05)。 结论:利格列汀能提高NAFLD合并2型糖尿病患者脂肪肝的临床疗效,控制血糖水平,改善胰岛功能、肝功能以及肝纤维化程度,且具有较高的用药安全性。
Objective To explore the effects of linagliptin on blood glucose,islet function and liver stiffness measurement(LSM)in patients with non-alcoholic fatty liver disease(NAFLD)and type 2 diabetes mellitus(T2DM).Methods During the period from January 2019 to April 2020,102 patients with NAFLD and T2DM in the Second Affiliated Hospital of Suzhou University were enrolled and divided into study group and control group according to different treatment methods,with 51 cases in each group.The control group was treated with metformin,while study group was treated with linagliptin and metformin.The clinical curative effect on fatty liver was observed and compared between the two groups.The levels of fasting blood glucose(FBG),glycated hemoglobin(HbA1c),homeostasis model assessment of insulin resistance(HOMA-IR),homeostasis model assessment of islet insulin cell function indexβ(HOMA-β),alanine aminotransferase(ALT),serum aspartate aminotransferase(AST),glutamyl transpeptidase(GGT)and LSM before and after treatment were compared between the two groups.The occurrence of adverse reactions during treatment in both groups was recorded.Results The total response rate of fatty liver treatment in study group was significantly higher than that in control group:96.1%(49/51)vs.82.4%(42/51),and there was statistical difference(P<0.05).After treatment,levels of FBG,HbA1c,HOMA-IR,serum ALT,AST,GGT and LSM in study group were significantly lower than those in control group:(7.1±1.0)mmol/L vs.(7.9±0.9)mmol/L,(7.5±0.7)%vs.(7.9±1.0)%,3.2±0.2 vs.4.7±0.3,(56.7±10.4)U/L vs.(62.8±8.2)U/L,(73.2±6.8)U/L vs.(81.1±6.7)U/L,(56.4±10.2)U/L vs.(62.3±8.1)U/L,(10.5±3.3)kPa vs.(13.4±1.6),the level of HOMA-βwas significantly higher than that in control group:48.5±8.3 vs.41.2±7.1,and there were statistical differences(P<0.05).The incidence of adverse reactions during treatment was low in both groups,and the difference was not statistically significant between the two groups(P>0.05).Conclusions Linagliptin can improve clinical curative effect
作者
乔鹏
张华
马妍菁
王晓晖
Qiao Peng;Zhang Hua;Ma Yanjing;Wang Xiaohui(Department of Pharmacy,the Second Affiliated Hospital of Suzhou University,Jiangsu Suzhou 215004,China)
出处
《中国医师进修杂志》
2021年第1期44-48,共5页
Chinese Journal of Postgraduates of Medicine
基金
苏州市2019年度科技发展计划项目(SYSD2019180)。
关键词
糖尿病
非酒精性脂肪肝
利格列汀
胰岛功能
Diabetes mellitus
Non-alcoholic fatty liver disease
Linagliptin
Islet function
