二甲双胍联合吡格列酮治疗非酒精性脂肪性肝病  

The Therapeutic Effects of Metformin Combined with Pioglitazone to Non-alcoholic Fatty Liver Diseases

作　　者：李桂平[1] 李红卫[1] 彭娜[1] 李绪娴[1] 钟思干[1] 

机构地区：[1]惠州市人民医院内科,广东惠州516002

出　　处：《贵阳医学院学报》2008年第5期491-494,共4页Journal of Guiyang Medical College

摘　　要：目的:观察二甲双胍及吡格列酮对非酒精性脂肪性肝病(NAFLD)的治疗效果。方法:136例NAFLD患者,随机分为对照组、二甲双胍治疗组、吡格列酮治疗组、联合治疗组。疗程6月,比较各组治疗前后的体重指数(BMD)、腰臀比(WHR)、血压、血脂、肝酶学、肿瘤坏死因子(TNF-α)、空腹血糖(FPG)、空腹血胰岛素(FINS)及胰岛素抵抗指数(HOMA-IR)。记录症状、体征、肝脏B超和CT表现。结果:药物治疗组患者的血总胆固醇(TC)、甘油三酯(TG)、谷丙转氨酸(AST)、谷草转氨酶(ALT)、r-谷氨酞转移酶(GGT)、HOMA-IR均较治疗前明显改善,TNF-α明显下降(P<0.05),总有效率明显高于对照组(P<0.01)。二甲双胍治疗组与吡格列酮治疗组疗效相近,合并应用二者的疗效显著优于单独应用二甲双胍或吡格列酮治疗的效果。结论:二甲双胍与吡格列酮均对NAFLD的治疗安全有效,联合用药效果优于单药治疗。Objective： To evaluate the therapeutic effects of mefformin and pioglitazone to non-alcoholic fatty liver diseases （NAFLD）. Methods： One hundred and thirty-six NAFLD patients were radomly divided into 4 groups： Patients in group A were offered with therapeutic life style advice; patients in group B were treated with metformin; patients in group C treated with pioglitazone; and pa- tients in group D treated with pioglitazone plus mefformin. The therapeutic results were compared in 6 months. The evaluating indexes including body mass index （BMI）, waist-to-hip ratio （WHR）, blood pressure, blood lipid, liver enzyme activities, tumor necrosis factor α（TNF-α）, （FBG）, fasting blood insulin （FBI）, insulin resistance index （IRt）, clinical fasting blood glucose symptoms, physical signs, and results of B-ultrasonic examination and CT scanning in liver. Results： In groups of B, C, and D, Levels of TC, TG, AST, ALT, GGT, and IRI were obviously improved than those before the treatment, and TNF-α level markedly decreased （P 〈 0.05 ）. The total effective rates in these groups were significantly higher than that in group A （ P 〈 0.01 ）. The therapeutic results of groups B and C were similar, and results obtained in group D were more satisfied than those in groups B and C. Conclusions： The treatment of pioglitazone or mefformin is safe and effective to NAFLD, and the therapeutic effect of their combination is superior to that of pioglitazone or mefformin alone.

关 键 词：肝疾病 二甲双胍 吡格列酮 非酒精性脂肪性肝病 

分 类 号：R575.1[医药卫生—消化系统]