瑞舒伐他汀联合二甲双胍对2型糖尿病并发非酒精性脂肪肝患者肝功能和炎症因子的影响

Effects of rosuvastatin combined with metformin on liver function and inflammatory factors in patients with T2DM complicated with NAFLD

目的探究瑞舒伐他汀钙片联合盐酸二甲双胍片对2型糖尿病并发非酒精性脂肪性肝病患者的肝功能指标、炎症因子水平及生化指标的影响。方法选择延安市人民医院于2017年10月—2018年10月收治的2型糖尿病并发非酒精性脂肪性肝病患者600例,根据其入院顺序随机均分为两组,每组各300例。对照组给予患者盐酸二甲双胍片进行治疗,500 mg/次,2次/d。观察组在对照组基础上联合瑞舒伐他汀钙片进行治疗,10 mg/次,1次/d。两组均持续治疗2个月。对比两组的肝功能指标、炎症因子水平及生化指标。结果治疗后,两组的丙氨酸氨基转移酶(ALT)、门冬氨酸氨基转移酶(AST)、碱性磷酸酶(ALP)、谷氨酰转肽酶(GGT)等肝功能指标均比治疗前显著降低(P<0.05);且观察组显著低于对照组(P<0.05)。治疗后,两组的白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)等炎症因子水平均比治疗前显著降低(P<0.05),且观察组显著低于对照组(P<0.05)。治疗后,两组的同型半胱氨酸(Hcy)、胱抑素C(Cys C)、猪硫氧还蛋白相互作用蛋白(TXNIP)均比治疗前显著降低(P<0.05),且观察组显著低于对照组(P<0.05);而Nesfatin-1水平均比治疗前显著升高(P<0.05),且观察组显著高于对照组(P<0.05)。结论瑞舒伐他汀钙片联合盐酸二甲双胍片可有效改善2型糖尿病并发非酒精性脂肪性肝病患者的肝功能指标和抑制炎症反应,并调节患者血清Nesfatin-1等生化指标水平,临床应用效果显著。

Objective To investigate the effects of Rosuvastatin Calcium Tablets combined with Metformin Hydrochloride Tablets on liver function,inflammatory factors and biochemical parameters in patients with type 2 diabetes mellitus(T2 DM)complicated with nonalcoholic fatty liver disease(NAFLD).Methods Patients(600 cases)with T2 DM complicated with NAFLD admitted to Yan’an People’s Hospital from October 2017 to October 2018 were enrolled.They were divided into two groups according to the order of admission,and each group had 300 cases.Patients in the control group were treated with Metformin Hydrochloride Tablets,500 mg/time,twice daily.Patients in the observation group were treated with Rosuvastatin Calcium Tablets on the basis of control group,10 mg/time,once daily.Patients in two groups were treated for 2 months.After 2 months of treatment,the liver function indexes,inflammatory factor levels and biochemical indicators were compared between two groups.Results After treatment,the liver function indexes of ALT,ALP,AST and GGT were significantly lower than those before treatment(P<0.05),and the indexes in the observation group was significantly lower than those in the control group(P<0.05).After treatment,the levels of IL-6 and TNF-α,and CRP in two groups were significantly lower than those before treatment(P<0.05),and the inflammatory factors levels in the observation group was significantly lower than those in the control group(P<0.05).After treatment,the levels of Hcy,Cys C,and TXNIP in two groups were significantly decreased(P<0.05),and the indexes in the observation group was significantly lower than those in the control group(P<0.05).And the ratio of Nesfatin-1 in two groups were significantly increased(P<0.05)the Nesfatin-1 in the observation group was significantly higher than those in the control group(P<0.05).Conclusion Rosuvastatin Calcium Tablets combined with Metformin Hydrochloride Tablets can effectively improve the liver function indexes and inhibit the inflammatory response in patients with T2 DM complicated with NAFLD,and regulate the serum levels of Nesfatin-1 and other biochemical indicators.The clinical application effect is significant.