利拉鲁肽与贝那鲁肽辅助治疗2型糖尿病伴非酒精性脂肪肝的临床对比研究  

Clinical comparative study of liraglutide and benaglutide in adjuvant treatment of T2DM patients complicated with nonalcoholic fatty liver disease

作　　者：佘雪梅[1] 田沛文[1] She Xuemei;TianPeiwen(Department of Endocrinology,the Fifth People's Hospital of Datong,Datong,Shanxi 037009,China)

机构地区：[1]大同市第五人民医院内分泌科,山西省037009

出　　处：《中国基层医药》2020年第19期2329-2333,共5页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的:比较利拉鲁肽与贝那鲁肽辅助治疗2型糖尿病(T2DM)伴非酒精性脂肪肝(NAFLD)的临床疗效。方法:选取大同市第五人民医院2017年1月至2019年1月收治的T2DM伴NAFLD患者共110例,采用随机数字表法分为对照组(55例)和观察组(55例),在二甲双胍基础上分别辅以利拉鲁肽和贝那鲁肽皮下注射治疗,比较两组治疗前后体质量指数(BMI)、腰围、空腹血糖(FPG)、餐后2 h血糖(2 h PG)、糖化血红蛋白(HbA1c)、空腹胰岛素(FINS)释放水平、胰岛素抵抗指数(HOMA-IR)、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、脂肪受控衰减参数(CAP)及肝脏硬度(LSM)水平。结果:两组治疗后BMI、腰围、FBG、2 h PG、HbA1c、FINS、HOMA-IR、血脂指标、ALT、AST、CAP及LSM水平均显著优于治疗前(t=3.17,3.80;4.95,5.66;3.41,3.50;3.85,5.06;4.43,4.60;3.55,4.17;3.91,4.07;3.26,3.59;4.10,5.27;4.01,4.89;3.62,3.20;3.97,4.62;4.01,5.37;4.66,5.13;4.95,5.87;均P<0.05);对照组治疗后BMI、腰围、2 h PG、ALT、AST、CAP及LSM分别为(22.01±0.98)kg/m^2、(1.63±0.38)cm、(7.04±1.71)mmol/L、(39.31±4.92)U/L、(31.40±4.94)U/L、(197.48±36.39)dB/m、(7.42±1.34)kPa,观察组治疗后BMI、腰围、2 h PG、ALT、AST、CAP及LSM分别为(19.87±0.76)kg/m^2、(0.89±0.21)cm、(6.29±1.10)mmol/L、(36.17±3.16)U/L,(28.63±3.59)U/L、(152.77±30.18)dB/m、(6.17±1.06)kPa,观察组治疗后BMI、腰围、2 h PG、ALT、AST、CAP及LSM均显著低于对照组(t=2.74、3.55、2.81、3.02、2.76、2.89、3.15,均P<0.05)。结论:相较于利拉鲁肽,贝那鲁肽辅助治疗T2DM伴NAFLD可有效减轻体质量,改善餐后血糖水平,保护肝脏功能,并有助于抑制肝脏脂肪沉积。Objective:To compare the clinical effects of liraglutide and benaglutide in adjuvant treatment of type 2 diabetes mellitus(T2DM)patients complicated with nonalcoholic fatty liver disease(NAFLD).Methods:From January 2017 to January 2019,110 T2DM patients complicated with NAFLD were chosen in the Fifth People's Hospital of Datong and divided into two groups according to the random digital table method,with 55 patients in each group.On the basis of metformin,the control group was given liraglutide,and the observation group was given benaglutide.The levels of BMI,waist circumference,fasting blood glucose(FPG),postprandial 2h blood glucose(2 h PG),glycosylated hemoglobin(HbA1c),fasting insulin(FINS)release level,insulin resistance index(HOMA-IR),total cholesterol(TC),triglyceride(TG),low density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C),levels of glutamate aminotransferase(ALT),aminotransferase(AST),controlled attenuation parameter(CAP)and liver stiffness(LSM)before and after treatment of the two groups were compared.Results:After treatment,the levels of BMI,waist circumference,FBG,2 h PG,HbA1c,FINS,HOMA-IR,lipid index,ALT,AST,CAP and LSM of the two groups were significantly better than those before treatment(t=3.17,3.80;4.95,5.66;3.41,3.50;3.85,5.06;4.43,4.60;3.55,4.17;3.91,4.07;3.26,3.59;4.10,5.27;4.01,4.89;3.62,3.20;3.97,4.62;4.01,5.37;4.66,5.13;4.95,5.87;all P<0.05).After treatment,the levels of BMI,waist circumference,2 h PG,ALT,AST,CAP and LSM of the control group were(22.01±0.98)kg/m^2,(1.63±0.38)cm,(7.04±1.71)mmol/L,(39.31±4.92)U/L,(31.40±4.94)U/L,(197.48±36.39)dB/m,(7.42±1.34)kPa,respectively,which were significantly worse than those of the observation group[(19.87±0.76)kg/m^2,(0.89±0.21)cm,(6.29±1.10)mmol/L,(36.17±3.16)U/L,(28.63±3.59)U/L,(152.77±30.18)dB/m,(6.17±1.06)kPa](t=2.74,3.55,2.81,3.02,2.76,2.89,3.15,all P<0.05).Conclusion:Compared with liraglutide,benaglutide in adjuvant treatment of T2DM patients complicated with NAFLD can efficiently decrease body we

关 键 词：糖尿病 2型 脂肪肝 血糖 胰岛 肝功能试验 利拉鲁肽 贝那鲁肽 

分 类 号：R587.1[医药卫生—内分泌] R575.5[医药卫生—内科学]