利拉鲁肽联合吡格列酮治疗糖尿病合并脂肪肝患者的疗效

Efficacy of liraglutide combined with pioglitazone in treatment with diabetes mellitus complicated with fatty liver

目的探讨利拉鲁肽联合吡格列酮对糖尿病合并脂肪肝患者治疗的临床效果。方法选取2015年4月到2017年4月间于本院进行治疗的112例糖尿病合并脂肪肝患者,随机分成观察组(n=56)和对照组(n=56)。对照组患者使用二甲双胍与利拉鲁肽治疗,观察组在对照组用药的基础上,增加吡格列酮进行治疗。观察比较两组患者治疗前后血脂水平、血糖水平、肝功能和肝脂肪含量。结果与治疗前比较,治疗后两组患者总胆固醇(TC)、低密度脂蛋白(LDL)、高密度脂蛋白(HDL)和甘油三酯(TG)等指标均明显改善(P<0.05),且观察组患者改善效果明显优于对照组(P<0.05);与治疗前比较,治疗后两组患者糖化血红蛋白(Hb A1c)、餐后2 h血糖(2h PG)和空腹血糖(FPG)等指标均显著降低(P<0.05),且观察组患者降低程度优于对照组(P<0.05);与治疗前比较,治疗后两组患者丙氨酸基转移酶(ALT)、天冬氨酸氨基转移酶(AST)和肝脂肪含量等指标均明显改善(P<0.05),且治疗后观察组患者改善情况明显优于对照组(P<0.05)。对照组不良反应发生率为8.93%,观察组为10.71%,两组比较差异无统计学意义(P>0.05)。结论利拉鲁肽联合吡格列酮可以改善糖尿病合并脂肪肝患者血脂、血糖水平,改善患者肝功能,降低肝脂肪含量,值得应用推广。

Objective To explore the clinical outcome of combination treatment of liraglutide and pioglitazone on diabetic patients with fatty liver. Methods A total of 112 patients with diabetes mellitus complicated with fatty liver who were treated in our hospital from April 2015 to April 2017 were randomly divided into observation group（n=56）and control group（n=56）. The patients in the control group were treated with metformin and liraglutide,and the observation group was treated with pioglitazone on the basis of the control group. The levels of blood lipid,blood glucose,liver function and liver fat were observed before and after treatment. Results Compared with those before treatment,total cholesterol（TC）,low density lipoprotein（LDL）,high density lipoprotein（HDL）and triglyceride（TG）and other indexes were significantly improved（P〈0.05）,and the improvement effect in the observation group was significantly better than that in the control group（P〈0.05）. Compared with before treatment,the levels of Hb A1 c,the indexes of 2 h postprandial blood glucose（2 h PG）and fasting plasma glucose（FPG）were significantly decreased（P〈0.05）. After treatment,the indexes of Hb A1 c,2 h PG and FPG in the observation group were significantly higher than those in the control group（P〈0.05）. Compared with those before treatment,the improvement of the alanine aminotransferase（ALT）,aspartate aminotransferase（AST）and liver fat content（P〈0.05）levels in the observation group was better than that in the control group（P〈0.05）. The incidence of adverse reactions in the control group was 8.93%, while that in the observation group was 10.71%. There was no significant difference between the two groups（P〉0.05）. Conclusion Liliprofen combined with pioglitazone in the treatment of diabetic patients with fatty liver had good clinical effect,and could improve the blood lipids,blood glucose levels,and liver function,and reduce liver fat content. This treatment has a high clinical value,and worthy of promotion.