西格列汀联合二甲双胍治疗Ⅱ型糖尿病合并脂肪肝的疗效观察

Clinical observation of the efficacy of sitagliptin combined with metformin on the treatment of type 2 diabetes mellitus with non-alcoholic fatty liver

目的观察西格列汀联合二甲双胍对新诊断Ⅱ型糖尿病(T2DM)合并非酒精性脂肪肝(NAFLD)患者的临床疗效。方法将收治的新发Ⅱ型糖尿病合并脂肪肝患者36例随机分为两组,在生活方式干预治疗基础上,治疗组18例给予二甲双胍500 mg,3次/日口服,西格列汀100 mg,1次/日口服。对照组18例只给予二甲双胍500 mg,3次/日口服。两组均治疗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。结果与对照组比较,治疗组肝酶、糖化血红蛋白、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88.0%,对照组有效率为33.0%,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)。结论西格列汀联合二甲双胍可明显改善Ⅱ型糖尿病合并脂肪肝患者的糖死血红蛋白、甘油三酯等生化指标,脂肪肝临床治疗效果显著。

Objective To observe the clinical efficacy of sitagliptin combined with metformin on the treatment of newly diagnosed type 2 diabetes mellitus （T2DM） accompanying non-alcoholic fatty liver disease （NAFLD）. Methods 36 patients with T2DM accompanying NAFLD were randomly divided into treatment group and control group. The treat- ment group was treated with metformin （500mg tid） plus sitagliptin （100mg qd）, and the control group was treated with metformin （500mg rid） on the basis of lifestyle intervention therapy. After treatment for 16 weeks, the therapeutic effectiveness in two groups was analyzed. The synthetic judgement according to physical signs, B-altrasonie examination in liver and biochemical laboratory results, and adverse events were recorded. Results Compared with control group, the improvements of liver enzyme, glycocylated hemoglobin （HbAle） ,tryglieeride （TG） in treatment group were better than those in control group（P〈0.05）. As to the efficacy of fatty liver, the genenal efficiency of treatment group and control group was 83% and 29% of （P〈0.01）. Adverse events had no significant difference between the two groups（P〉 0.05）. Conclusion Sitagliptin combined with metformin is a new kind of safe and effective treatment for T2DM accompanying NAFLD.