二甲双胍用于治疗肝硬化合并糖尿病的研究进展

Research Progress of Metformin in the Treatment of Cirrhosis with Diabetes

二甲双胍(Metformin)作为治疗2型糖尿病(T2DM)的一线口服药物,近年来已被证实能改善肝纤维化进展,减少肝细胞癌(Hepatic cell carcinoma, HCC)、肝性脑病(Hepatic encephalopathy, HE)等严重结局的发生,提高患者的生活质量,延长生存周期。但对于合并肝肾综合征(Hepatorenal syndrome, HRS)、食管胃底静脉曲张破裂出血(Esophagogastric variceal bleeding, EGVB)的患者,使用二甲双胍可能存在一定风险。因此,针对肝硬化合并糖尿病患者,合理的使用二甲双胍对提高患者的生存率具有较大意义。本文就二甲双胍应用于肝硬化合并糖尿病患者的风险及临床获益进行一定的总结与讨论。

Metformin, as a first-line drug for the treatment of type 2 diabetes, has been proven to improve the progression of cirrhosis and reduce the risk of hepatocellular carcinoma hepatic encephalopathy in recent years, thus improving the life quality and survival time of patients. Nevertheless, metformin may be risky for patients with hepatorenal syndrome or esophagogastric variceal bleeding. There-fore, it is significant for patients who suffer from cirrhosisi to improve the survival rate. This paper summarizes and discusses the clinical benefits and risks of metformin in patients of cirrhosis with diabetes.