利格列汀联合二甲双胍在2型糖尿病合并脂肪肝治疗中的临床观察

Clinical Observation on the Efficacy of Linagliptin Combined with Metformin in the Treatment of Type 2 Diabetes Mellitus with Non-Alcoholic Fatty Liver

目的观察利格列汀联合二甲双胍对初发2型糖尿病(T2DM)合并非酒精性脂肪肝(NAFLD)患者的临床疗效。方法 35例初发2型糖尿病合并NAFLD患者随机分为2组,在生活方式干预治疗基础上,治疗组给予二甲双胍500 mg,tid,口服;利格列汀5 mg,qd,口服,对照组给予二甲双胍500 mg,tid,口服治疗16周后,根据体征、肝脏B超和各项生化指标判断两组患者的疗效,记录不良事件。结果与治疗前比较,两组患者各项指标明显改善(P<0.05);与对照组比较,治疗组肝酶糖化血红蛋白胰岛素抵抗指数甘油三酯改善更明显(P<0.05),两组患者脂肪肝疗效比较,治疗组有效率为83%,对照组有效率为29%,差异有统计学意义(P<0.01),两组不良反应差异无统计学意义(P>0.05)。结论利格列汀联合二甲双胍是一种新型安全有效的T2DM合并NAFLD的治疗方案。

Objective To observe the clinical efficacy of linagliptin combined with metformin in the treatment of patients of newly diagnosed type 2 diabetes mellitus （T2DM） accompanying non-alcoholic fatty liver disease （ NAFLD）. Methods 35 patients with T2DM accompanying NAFLD were randomly divided into two groups. the treatment group was treated with metformin （500 mg,tid） plus linagliptin （5 mg,qd） and the control group was treated with metformin （500 mg,tid） on the basis of li-festyle intervention therapy. After treatment for 16 weeks,The therapeutic effectiveness in two group was analyzed by synthetic judgment according to physical signs ,B- ultrasonic examination in liver and biochemical laboratory results,and adverse events were recorded. Results Compared with before treatment, there were significant difference in two groups（P〈0. 05）, Compared with control group, The improvements of liver enzyme,glycosylated hemoglobin （HbA1c） ,insulin resistance index （HOMA-IR）,triglyceride （TG） in treatment group were better than those in control group （P〈0. 05）. As to the efficacy of fatty liver,the general efficiency of treatment group was 89% while 29% of control group, the difference was significant （P〈0. 01）. Adverse events had no significant difference be-tween the two groups（P〉0. 05）. Conclusion Linagliptin combined with metformin is a new kind of safe and effective treatment for T2DM accompanying NAFLD.