西格列汀治疗初发2型糖尿病伴非酒精性脂肪肝的疗效及对患者血糖、血脂的影响

Efficacy of Sitagliptin on the Onset of Type 2 Diabetes Complicated with Non-alcoholic Fatty Liver and Effect on Blood Glucose and Blood Lipid

目的:比较西格列汀联合二甲双胍与格列美脲联合二甲双胍治疗初发2型糖尿病伴非酒精性脂肪肝的临床疗效及安全性。方法:160例初发2型糖尿病伴非酒精性脂肪肝患者随机分为对照组与观察组各80例。两组均采用二甲双胍片0.5 g,po,bid基础治疗,对照组同时给予格列美脲片2 mg,po,qd,观察组同时给予西格列汀片100 mg,po,qd。分别于治疗前、治疗16周后检测两组患者空腹血糖、餐后2 h血糖、肝功能、血脂等指标,比较两组临床疗效与药品不良反应。结果:观察组患者脂肪肝改善总有效率为88.75%,明显高于对照组的61.25%(P<0.05);治疗16周后,两组患者肝功能和胰岛素抵抗指数均较治疗前明显改善(P<0.05),且观察组较对照组改善更显著(P<0.05);两组血糖及血脂水平较治疗前明显下降(P<0.05),但组间比较差异无统计学意义(P>0.05)。治疗期间两组患者均未发生严重不良反应。结论:西格列汀联合二甲双胍治疗初发2型糖尿病伴非酒精性脂肪肝,相比格列美脲联合二甲双胍效果更显著,且安全。

Objective： To compare the clinical efficacy and safety of sitagliptin combined with metformin and glimepiride combined with metformin in the treatment of newly diagnosed type 2 diabetes with non-alcoholic fatty liver. Methods： Totally 160 cases diagnosed as early onset type 2 diabetes with non-alcoholic fatty liver were randomly selected and divided into the control group and the treatment group with 80 ones in each. Both groups were treated with metformin 0.5 g,po, bid, and the control group was with glimepiride tablets （2 mg,po, qd） and the treatment group was treated with sitagliptin tablets （100 mg,po, qd） additionally. Before the treatment and after the 16-week treatment, fasting blood glucose, 2h postprandial blood glucose, liver function, blood lipids, fatty liver clinical efficacy and adverse reactions were detected in the two groups. Results： The total effective rate of fatty liver in the treatment group was 88.75%, which was significantly higher than that in the control group （61.25 %, P 〈 0.05 ）. After the 16-week treatment, the liver function and insulin resistance index in the two groups were significantly improved when compared with those before the treatment, and the improvement of the treatment group was more significant than that of the control group （P 〈 0.05）. The glucose and lipid levels in the two groups were significantly decreased after the treatment （ P 〈 0.05 ） , while there was no significant difference between the two groups （P 〉 0.05 ）. Severe adverse reactions did not occur during the treatment in the two groups. Conclusion： Sitagliptin combined with metformin is more effective and safer than glimepiride combined with metformin in the treatment of early onset type 2 diabetes com- plicated with non-alcoholic fatty liver.