还原型谷胱甘肽联合二甲双胍治疗2型糖尿病并发脂肪肝疗效观察

Curative effect of glutathione united with two armor biguanide on type 2 diabetes mellitus complicated with fatty liver

①目的探讨还原型谷胱甘肽(GSH)联合二甲双胍(m etform in)治疗糖尿病并发脂肪肝的疗效。②方法48例糖尿病并发脂肪肝患者,均在运动与饮食治疗基础上,常规护肝治疗;用还原型谷胱甘肽1 200mg,加入5%葡萄糖注射液250mL中,每日1次,静脉滴注,每次口服二甲双胍片0.25g,每日3次。3个月为一疗程,观察有关指标及B超影像学改变。③结果经治疗后患者丙氨酸转氨酶(ALT)、天门冬氨酸转氨酶(AST)、谷氨酰转肽酶(GGT)降至正常(P<0.001),血总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)及体重指数(BM I)值较治疗前显著降低(P<0.001),空腹血糖(FPG)、糖化血红蛋白(HbA1 c)较治疗前下降(P<0.001),计算比较稳态模式胰岛素抵抗指数(HOMA-IR)和稳态模式胰岛素敏感指数(HOMA-IAI)值,差异具有显著性意义(P<0.005)。④结论对伴有脂肪肝的2型糖尿病患者应用还原型谷胱甘肽联合二甲双胍治疗,能有效地改善胰岛素抵抗,提高胰岛素敏感性,具有降酶、降糖、调脂的功效,疗效较好。

Objective To cxplore the effect of glutatbione （GSH） unites two armor biguanides （Mefformin） on the treatment of type 2 diabetes meitus complicated with fatty liver and its possible mechanism. Methods Thirty type 2 diabetes mellitus（DM） patients complicated with fatty liver were selected to be treated with glutathione 1200rag, Joins in 5% glucose inoculation fluid 250ml,Every day, Vein intravenous drip,Takes orally two armor biguanides piece 0.25g/tine ,3 tine/doy,3 months are a treatment course,The related indices and B ultrasonic were detected. Results ALT, AST, GGT, TC, TG, LDL -C, BMI, FPG and HbAlc levels after glutathione unites two armor biguanides treatment were all significantly lower than those before treatment（ P 〈 0. 001 ） , and there was markedly difference of HOMA - IR and HOMA - IAI before and after treatment （P 〈 0. 005, P 〈 0. 001 ）. Conclusion glutathione united with two armor biguanid treatment for type 2 DM patients complicated with fatty liver can improve effectively the resistance of insulin and play important role in decreasing ALT, AST and FPG and regulating blood lipid.