度拉糖肽联合达格列净对非酒精性脂肪肝合并2型糖尿病患者的胰岛素抵抗和肝功能的影响  

Effect of Dulaglutide combined with Dapagliflozin on insulin resistance and liver function in pa-tients with NAFLD combined with T2MD

作　　者：陈小莹 陈宜德 卓徐鹏 林慧[1] 江凌翔[1] Chen Xiaoying;Chen Yide;Zhuo Xupeng;Lin Hui;Jiang Lingxiang(General Practice,Taizhou First People′s Hospital,Taizhou,Zhejiang 318020,China)

机构地区：[1]台州市第一人民医院全科医学,浙江台州318020

出　　处：《中国药物与临床》2024年第16期1073-1077,共5页Chinese Remedies & Clinics

摘　　要：目的探究度拉糖肽联合达格列净治疗非酒精性脂肪肝(NAFLD)合并2型糖尿病(T2MD)的效果及对胰岛素抵抗和肝功能的影响。方法选取2020年11月至2022年11月浙江省台州市第一人民医院诊治的88例NAFLD合并T2MD患者,根据治疗方案分为2组,其中对照组(44例)接受达格列净治疗,联合组(44例)接受度拉糖肽联合达格列净治疗。连续治疗3个月后评估2组临床疗效和不良反应,比较2组胰岛素抵抗、肝功能、糖脂代谢指标。结果联合组临床疗效(89%)高于对照组(73%)(χ^(2)=4.021,P<0.05);联合组治疗后血清丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、γ-谷氨酰转肽酶(γ-GT)水平及胰岛抵抗指数(HOMA-IR)值低于对照组,胰岛素β细胞功能(HOMA-β)值高于对照组(t=2.841、3.102、2.985、2.018、2.394,P均<0.05);联合组治疗后空腹血糖(FPG)、餐后2 h血糖(2 h PG)、糖化血红蛋白(HbA1c)低于对照组(t=2.621、3.961、2.143,P均<0.05);联合组治疗后血清总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)低于对照组、血清高密度脂蛋白胆固醇(HDL-C)高于对照组(t=2.394、3.114、2.514、2.098,P均<0.05);2组不良反应发生情况比较,差异无统计学意义(χ^(2)=1.027,P>0.05)。结论度拉糖肽联合达格列净治疗NAFLD合并T2MD可明显改善其胰岛素抵抗和肝功能,治疗效果明显,值得临床推广。Objective To explore the efficacy of Dulaglutide combined with Dapagliflozin the treatment of nonalcoholic fatty liver disease(NAFLD)with type 2 diabetes mellitus(T2MD)and its influence on insulin resistance and liver function.Methods A total of 88 patients with NAFLD combined with T2MD who were diagnosed and treated at Taizhou First People′s Hospital from November 2020 to November 2022 were selected and divided into two groups based on different treatment plans.The control group(n=44)received treatment with dapagliflozin tablets,while the combination group(n=44)received treatment with dulaglutide combined with dapagliflozin.After continuous treatment for 3 months,the clinical efficacy and adverse reactions of the two groups were evaluated,and the insulin resistance,liver function,and glucose and lipid metabolism indicators between the two groups were compared.Results The clinical efficacy of the combination group(89%)was higher than that of the control group(73%)(χ^(2)=4.021,P<0.05).the levels of serum alanine aminotransferase(ALT),aspartate aminotransferase(AST)and glutamyl transpeptidase(γ-GT)and the values of HOMA-IR after treatment in the combined group levels were lower than the control group,and the values of HOMA-βwere higher than those in the control group(t=2.841,3.102,2.985,2.018,2.394,all P<0.05).After treatment,the levels of fasting blood glucose(FBG),2-hour postprandial blood glucose(2 h PG),and glycosylated hemoglobin(HbA1c)in the combined group were lower than those in the control group(t=2.621,3.961,2.143,all P<0.05).After treatment,the levels of serum total cholesterol(TC),triglyceride(TG)and low-density lipoprotein cholesterol(LDL-C)in the combined group were lower than those in the control group,and the levels of serum high-density lipoprotein cholesterol(HDL-C)were higher than those in the control group(t=2.394,3.114,2.514,2.098,all P<0.05).There was no statistically significant difference in the occurrence of adverse reactions between the two groups(χ^(2)=1.027,P>0.05).Conclusion The c

关 键 词：非酒精性脂肪性肝病 糖尿病 2型 胰岛素抵抗 肝功能 

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