摘要
目的:探讨达格列净联合利拉鲁肽对2型糖尿病(T2DM)合并非酒精性脂肪性肝病(NAFLD)患者炎症因子、糖脂代谢和肝功能的影响。方法:将2020年3月至2021年5月该院内分泌科收治的135例T2DM合并NAFLD患者使用计算机的SAS统计软件随机分为达格列净组、利拉鲁肽组和联合组,各45例。在生活干预的基础上,达格列净组、利拉鲁肽组和联合组患者分别采用达格列净、利拉鲁肽和达格列净联合利拉鲁肽治疗。观察三组患者治疗前后血清超敏C反应蛋白(hs-CRP)、可溶性白细胞介素2受体(SIL-2R)等炎症指标,糖化血红蛋白(HbA_(1)c)、三酰甘油葡萄糖指数(TyG)等糖脂代谢指标,丙氨酸转氨酶(ALT)、胆汁酸(TBA)等肝功能指标,脂肪肝指数(FLI)和肝脏硬度(LSM)等肝脏物理指标水平的变化,并观察药品不良反应发生情况。结果:治疗20周后,三组患者的hs-CRP、SIL-2R水平较治疗前显著降低,联合组患者显著低于达格列净组和利拉鲁肽组,差异均有统计学意义(P<0.05);三组患者的HbA_(1)c、TyG水平较治疗前显著降低,联合组患者显著低于达格列净组和利拉鲁肽组,差异均有统计学意义(P<0.05);三组患者的ALT和TBA水平较治疗前显著降低,差异有统计学意义(P<0.05),但三组患者组间比较的差异均无统计学意义(P>0.05);三组患者的FLI、LSM水平较治疗前显著降低,联合组患者显著低于达格列净组和利拉鲁肽组,差异均有统计学意义(P<0.05)。达格列净组、利拉鲁肽组和联合组患者的不良反应发生率分别为6.67%(3/45)、8.89%(4/45)和11.11%(5/45),差异无统计学意义(P>0.05)。结论:达格列净和利拉鲁肽能有效减轻T2DM合并NAFLD患者的炎症水平,改善糖脂代谢紊乱,促进脂肪肝的恢复,联合用药效果更佳。
OBJECTIVE:To probe into the effects of dapagliflozin combined with liraglutide on inflammatory factors,glucolipid metabolism and liver function in patients with type 2 diabetes(T2DM)combined with non-alcoholic fatty liver disease(NAFLD).METHODS:A total of 135 patients with T2DM complicated with NAFLD admitted into the endocrinology department of the hospital from Mar.2020 to May 2021 were extracted to be divided into the dapagliflozin group,liraglutide group and combination group,with 45 cases in each group using SAS statistical software.On the basis of life intervention,patients in the dapagliflozin group,liraglutide group and combination group were treated with dapagliflozin,liraglutide and dapagliflozin combined with liraglutide,respectively.Serum inflammatory indicators such as high sensitivity C-reactive protein(hs-CRP)and soluble interleukin-2 receptor(SIL-2R),glucose and lipid metabolism indicators such as glycated hemoglobin(HbA_(1)c)and triacylglycerol glucose index(TyG),and liver function indicators such as alanine aminotransferase(ALT)and bile acid(TBA),liver physical indicators such as fatty liver index(FLI)and liver hardness(LSM)before and after treatment,and adverse drug reactions of three groups were observed.RESULTS:After treatment of 20 weeks,the levels of hs-CRP and SIL-2R in three groups were significantly lower than those before treatment,and the combination group was significantly lower than the dapagliflozin group and liraglutide group,the differences were statistically significant(P<0.05).The levels of HbA_(1)c and TyG in three groups were significantly lower than those before treatment,and the combination group was significantly lower than the dapagliflozin group and liraglutide group,the differences were statistically significant(P<0.05).The levels of ALT and TBA in three groups were significantly lower than those before treatment,the differences were statistically significant(P<0.05),yet there was no significant difference among three groups(P>0.05).The levels of FLI and LSM in three gro
作者
储杨
王德琴
吕忠美
CHU Yang;WANG Deqin;LYU Zhongmei(Dept.of Nephroendocrinology,Hai’an Hospital Affiliated to Nantong University,Jiangsu Haian 226600,China)
出处
《中国医院用药评价与分析》
2022年第9期1064-1067,1071,共5页
Evaluation and Analysis of Drug-use in Hospitals of China
基金
江苏省卫生健康委科研课题(No.H2018053)。
关键词
2型糖尿病
非酒精性脂肪性肝病
达格列净
利拉鲁肽
糖脂代谢
肝功能
Type 2 diabetes
Non-alcoholic fatty liver disease
Dapagliflozin
Liraglutide
Glycolipid metabolism
Liver function
