艾塞那肽治疗2型糖尿病合并非酒精性脂肪性肝病患者的疗效观察

Effect of Exenatide therapy in type 2 diabetes with nonalcoholic fatty liver disease

目的观察艾塞那肽联合二甲双胍治疗2型糖尿病合并非酒精性脂肪性肝病患者的临床疗效。方法选取2型糖尿病合并非酒精性脂肪性肝病患者50例,随机分为试验组与对照组,每组25例。对照组应用二甲双胍治疗,试验组在二甲双胍基础上联合应用艾塞那肽治疗。治疗前及治疗12周后分别测量患者身高、体重、体重指数(BMI)、腰围(WC)、糖基化血红蛋白(HbA1c)、空腹血糖(FBG)、空腹C肽(FCP)、三酰甘油(TG)、胆固醇(TCH)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)、收缩压(SBP)、舒张压(DBP)、谷丙转氨酶(ALT)、超氧化物歧化酶(SOD)、肝脏脂肪含量(LFC)。结果两组治疗前基线资料无显著差异,治疗后试验组及对照组在WC、HbA1c、FBG及LFC方面较治疗前明显改善(P<0.05),且试验组较对照组改善更为显著,与对照组相比差异有统计学意义(P<0.05)。结论在BMI、WC、HbA1c、FBG、FCP、SBP、TG、TCH、HDL、LDL、LFC方面,艾塞那肽联合二甲双胍改善2型糖尿病合并非酒精性脂肪性肝病较单纯应用二甲双胍治疗疗效显著。

Objective To observe the therapeutic effect of exenatide combined with metformin therapy in type 2 diabetes with nonalcoholic fatty liver disease. Methods 50 patients with type 2 diabetes and nonalcoholic fatty liver disease were randomly divided into experimental group and control group with 25 cases in each. The control group were treated with metformin,the experimental group were treated with exenatide on the basis of metformin. Before treatment and at the end of 12-week treatment,patients height,weight,body mass index（BMI）,waistline（WC）,glycated hemoglobin（HbA1c）,fasting blood glucose（FBG）,fasting C-peptide（FCP）,triglyceride（TG）,cholesterol（TCH）,high density lipoprotein（HDL）,low density lipoprotein（LDL）,systolic pressure（SBP）,diastolic pressure（DBP）,alanine aminotransferase（ALT）,superoxide dismutase（SOD）,liver lipid contents（LFC） were detected. Results Baseline data were not significantly different between the two groups. Compared to baseline,WC,HbA1c,FBG and LFC in experimental group and control group were obviously improved after treatment（P〈0. 05）,and the experimental group improved more significantly than control group（P〈0. 05）. Conclusion Exenatide combined with metformin has an obvious therapeutic effect on BMI,WC,HbA1c,FBG,FCP,SBP,TG,TCH,HDL,LDL,LFC than mere metformin treatment in treatment of type 2 diabetes with nonalcoholic fatty liver disease.