马来酸罗格列酮对2型糖尿病合并非酒精性脂肪肝的疗效观察

The Clinical Effects of Rosiglitazone on Type 2 Diabetes Mellitus Combined with Non-alcoholic Fatty Liver

目的:评价罗格列酮对2型糖尿病(T2DM)合并非酒精性脂肪肝(NAFL)的作用,观察其疗效。方法:选择32例T2DM合并NAFL患者,在口服磺脲类、双胍类、α-糖苷酶抑制剂基础治疗上加用马来酸罗格列酮,采用治疗前后对照方法,观察空腹血糖(FPG),餐后2h血糖(2hPG),糖化血红蛋白(HbA1C),空腹胰岛素含量(FIns),胰岛素抵抗指数(HOMA-IR),胰岛素敏感指数(ISI),甘油三酯(TG),总胆固醇(TC),高密度脂蛋白(HDL-C),低密度脂蛋白(LDL-C),谷丙转氨酶(GPT),谷草转氨酶(GOT)等变化。并比较治疗前后肝脏彩色多普勒B超影像学改变。结果:加用马来酸罗格列酮治疗后,FPG、2hPG、HbA1C、FIns、HOMA-IR明显降低,ISI升高(P<0.01)。TC、TG、LDL-C、GPT、GOT显著下降(P<0.05),HDL-C变化无统计学意义。B超影像学显示脂肪肝明显减轻。结论:马来酸罗格列酮能改善T2DM合并NAFL患者的血糖和血脂谱,减少胰岛素抵抗,逆转肝脂肪变性和NAFL所致的肝脏酶谱升高。

Objective：To observe the clinical effects of rosiglitazone on type 2 diabetes patients combined with non-alcoholic fatty liver（NAFL）. Methods：A total of 32 eases of type 2 diabetes mellitus combined with NAFL reeieved rosiglitazone on the basis of the therapy of sulphonylurea, biguanides and ccglueosidase inhibitor. To cross-refer the treatment, many measurements were taken, including fasting plasma gloueose （FPG）, two-hour postprandial plasma gloueose（2hPG）, hemoglobin A1c（HbA1c）, fasting insulin （Fins）, insulin resistance index （IRI）, homeostatic model assessment,insulin sensitive index （ISI）, triglyeeride （TG）, total cholesterol （TC）, high density lipoprotein （HDL-C）, low density lipoprotein（LDL-C）,GPT, GOT and B-ultrasonic of liver. Results： Affer taking rosiglitazone, the levels of FPG, 2hPG, HbA1c, Fins and HOMA-IR decreased significantly, the level of ISI increased （P〈0. 01 for all）, and the levels of TC, TG, LDL-C, GPT and GOT decreased even more singnifieantly （P〈0. 05 for all）. B-ultrasonic examination of liver showed the improvement of fatty liver. Conclusion： Rosiglitazone can ameliorate the plasma gloueose and plasma lipid of the patients with type 2 diabetes combined with NAFL, reduce the insulin resistance, reverse the fatty degeneration of liver and increasing of hepatic enzyme chart induced by NAFL.