西格列他钠联合二甲双胍恩格列净对2型糖尿病合并非酒精性肝病的疗效分析  

Effect Analysis of Chiglitazar Combined with Metformin and Empa⁃gliflozin in the Treatment of Type 2 Diabetes Mellitus with Non-alcoholic Fatty Liver Disease

作　　者：段霖 林俊平 王建强 曹金涛 DUAN Lin;LIN Junping;WANG Jianqiang;CAO Jintao(Department of Endocrinology,the 970th Hospital of the People's Libeiation Army(Weihai Campus),Weihai 264200,Shandong,China)

机构地区：[1]解放军第970医院(威海院区)内分泌科,山东威海264200

出　　处：《糖尿病新世界》2024年第10期76-79,共4页Diabetes New World

摘　　要：目的探讨西格列他钠联合二甲双胍恩格列净对2型糖尿病(type 2 diabetes mellitus,T2DM)合并非酒精性脂肪肝病(non-alcoholic fatty liver disease,NAFLD)的疗效。方法选取2022年6月—2023年3月解放军第970医院(威海院区)收治的82例首诊糖化血红蛋白>7.5%或单药口服降糖效果不佳的T2DM合并NAFLD患者为研究对象,以治疗方法的不同分为观察组和对照组,各41例。两组均给予常规控制饮食、结合运动措施,对照组采用二甲双胍恩格列净复方制剂治疗,观察组在对照组治疗的基础上联合西格列他钠治疗。比较两组治疗前后胰岛素抵抗指数(homeostasis model assessment-insulin resistance,HOMA-IR)、体重指数、血糖(糖化血红蛋白、空腹血糖、餐后2 h血糖)、血脂(甘油三酯、总胆固醇)、肝功能指标(谷丙转移酶、谷草转移酶)及不良反应(胃肠道反应、低血糖)发生情况。结果治疗16周后,观察组血糖、血脂、肝功能指标、HOMA-IR水平均低于对照组,差异有统计学意义(P均<0.05)。两组体重指数及不良反应发生情况比较,差异无统计学意义(P均>0.05)。结论西格列他钠具有减轻胰岛素抵抗、改善糖脂代谢及治疗脂肪肝的作用,无明显低血糖、体重增加的不良反应,联合二甲双胍恩格列净治疗T2DM合并NAFLD的疗效较好。Objective To investigate the effect of chiglitazar combined with metformin and empagliflozin on type 2 dia-betes mellitus(T2DM)complicated with non-alcoholic fatty liver disease(NAFLD).Methods A total of 82 T2DM complicated with NAFLD patients with glycated hemoglobin A1c>7.5%or poor effect of single drug oral hypoglyce-mic drugs in The 970th Hospital of the People's Libeiation Army(Weihai Campus)from June 2022 to March 2023 were selected as the study subjects,and were divided into observation group and control group according to different treatment methods,with 41 cases in each group.Both groups were given conventional control diet combined with exer-cise measures,the control group was treated with metformin and enaglitazine compound preparation,and the observa-tion group was treated with chiglitazar on the basis of the control group.The homeostasis model assessment-insulin re-sistance(HOMA-IR),body mass index,blood glucose levels(glycated hemoglobin A1c,fasting plasma glucose,2-hour postprandial plasma glucose),blood lipid levels(triglyceride,total cholesterol),liver function indexes(alanine aminotransferase,aspartate aminotransferase),and incidence of adverse reactions(gastrointestinal reactions,hypogly-cemia)were compared between the two groups before and after treatment.Results After 16 weeks of treatment,the lev-els of blood glucose,blood lipid,liver function indexes and HOMA-IR in the observation group were lower than those in the control group,and the differences were statistically significant(all P<0.05).There were no significant differ-ences in body mass index and adverse reactions between the two groups(both P>0.05).Conclusion Chiglitazar can ef-fectively reduce insulin resistance,improve glucose and lipid metabolism and fatty liver without increasing adverse re-actions of body mass and hypoglycemia,chiglitazar combined with metformin and empagliflozin has a better effect in the treatment of T2DM with NAFLD.

关 键 词：西格列他钠 二甲双胍恩格列净 胰岛素抵抗 2型糖尿病 非酒精性脂肪肝病 

分 类 号：R587.1[医药卫生—内分泌]