摘要
目的：探讨西格列汀治疗2型糖尿病（T2DM）合并非酒精性脂肪肝病（NAFLD）的疗效。方法选取200例 T2DM合并 NAFLD 患者，将其按照随机数字表法分为观察组和对照组，每组100例，观察组采用西格列汀进行治疗，对照组采用二甲双胍进行治疗，监测患者治疗前及治疗3、6个月后的体质量、体质量指数（BMI）、肝功能（AST、ALT、GGT）、OGCT（同步抽血检测空腹及早餐后2 h 血糖、胰岛素）、血脂（TC、TG）、糖化血红蛋白（HbAlc）等生化指标，以及1HMRS 扫描图像。结果治疗后两组 ALT、GGT、AST、FPG 及2 h PG 均显著改善（t≥2．35，均 P ＜0．05），但观察组 ALT、GGT、AST、FPG 及2 h PG 改善情况优于对照组（t≥4．99，均 P ＜0．05）。治疗后两组 TC、TG、HbAlc、BMI、HOMA-IR 均显著改善（t≥5．63，均 P ＜0．05），但观察组改善更为明显（t≥3．90，均 P ＜0．05）。治疗后观察组肝脏脂质含量（IHCL）为（10．3±2．9）％，显著低于治疗前的（27．8±4．5）％（t ＝32．69，P ＜0．05）；治疗后对照组 IHCL 为（18．4±3．5）％，显著低于治疗前的（26．9±4．6）％（t ＝14．70，P ＜0．05），但观察组治疗后 IHCL 显著低于对照组治疗后（t ＝17．82，P ＜0．05）。结论西格列汀可显著改善 T2DM合并 NAFLD 患者的血糖、血脂、肝功能，缓和胰岛素抵抗，临床疗效好，值得推广。
Objective To evaluate the curative effects of sitagliptin in the treatment of type 2 diabetes mellitus complicated with nonalcoholic fatty liver disease（NAFLD）.Methods 200 type 2 diabetes mellitus patients with NAFLD were selected and randomly divided into the observation group and the control group,100 cases in each group.The observation group received sitagliptin treatment,while the control group was treated with metformin.Before and 3,6 months after treatment,the body weight,body mass index（BMI）,liver function（AST,ALT,GGT）,OGCT synchronous exsanguinate assay（fasting and 2 h after breakfast glucose,insulin）,blood lipid（TC,TG）and glycosylated hemoglobin（HbAlc）,and other biochemical indicators were monitored and compared,as well as 1HMRS scan images. Results In the two groups after treatment,ALT,GGT,AST,FPG and 2h PG all improved significantly（t≥2.35,P 〈0.05）,but ALT,GGT,AST,FPG and 2h PG in the observation group all improved better than those in the control group（t≥4.99,all P 〈0.05）.In the two groups after treatment,TC,TG,HbAlc,BMI,HOMA -IR all improved significantly（t≥5.63,all P 〈0.05）,but those of the observation group improved more significantly（t≥3.90,all P 〈0.05 ）.In the observation group after treatment,liver lipid content （IHCL）was （10.3 ±2.9 ）%,which was significantly lower than （27.8 ±4.5）% before treatment（t =32.69,P 〈0.05）.In the control group after treatment, IHCL was （18.4 ±3.5）%,which was significantly lower than （26.9 ±4.6）% before treatment（t =14.70,P 〈0.05）,but in the observation group after treatment IHCL was significantly lower than that in the control group after treatment（t =17.82,P 〈0.05）.Conclusion Sitagliptin can significantly improve the blood glucose,blood lipid, liver function,insulin resistance in type 2 diabetes mellitus patients with NAFLD,which has good clinical curative effects and is worthy of clinical promoting.
出处
《中国基层医药》
CAS
2016年第17期2576-2579,I0003,共5页
Chinese Journal of Primary Medicine and Pharmacy
基金
浙江省温州市科技计划项目（Y20140285）
关键词
糖尿病
2
型
脂肪肝
西格列汀
Diabetes mellitus,type 2
Fatty liver
Sitagliptin
