利拉鲁肽注射液对2型糖尿病合并非酒精性脂肪肝患者内质网应激的影响及其疗效分析

Effect of Liraglutide on ERS in T2DM and NAFLD patients and its clinic efficacy

目的观察利拉鲁肽对2型糖尿病(T2DM)合并非酒精性脂肪肝(NAFLD)患者内质网应激(ERS)的影响,并分析其临床疗效。方法选取我院2017年6月—2019年2月收治的T2DM伴发NAFLD患者144例,使用数字表法随机分为对照组和观察组,每组72例。对照组给二甲双胍,0.5g/次,2次/d,观察组给予利拉鲁肽,0.6mg/d,连用1周,以后1.2 mg/d,疗程12周。使用荧光定量PCR法检测内质网应激蛋白(CHOP)、激活转录因子6(ATF6)和分子伴侣葡萄糖调节蛋白78(GRP78)基因表达。比较两组临床疗效和不良反应。结果治疗前两组FBG、2 h PBG、HbA1c、HOMA-IR、TG、TC和LDL-C无显著性差异(P>0.05),治疗后观察组FBG、2 h PBG、HbA1c、HOMA-IR、TG、TC和LDL-C显著低于对照组(P<0.05)。治疗前两组CHOP、ATF6和GRP78基因表达2-△△Ct值无显著性差异(P>0.05),治疗后观察组CHOP、ATF6和GRP78基因表达2-△△Ct值显著低于对照组(P<0.05)。观察组临床治疗有效率为81.9%(59/72),显著高于对照组的62.5%(45/72)(P<0.05)。对照组不良反应发生率为2.8%(2/72),观察组不良反应发生率为4.2%(3/72),两组不良反应发生率无显著性差异(P>0.05)。结论利拉鲁肽可以降低T2DM伴发NAFLD患者的ERS,降低血糖和血脂,临床疗效显著,使用安全。

Objective To detect the effect of Liraglutide on endoplasmic reticulum stress(ERS)in type 2 diabetes mellitus(T2 DM)and non-alcoholic fatty liver disease(NAFLD)patients and analyze its clinic efficacy.Methods A total of144 patients were enrolled in this study.Who were divided into:control group(n=72)and observation group(n=72).The control group was given metformin(0.5 g/time,2 times/d for 12 weeks).The observation group was given Liraglutide(0.6 mg/d for 1 weeks,1.2 mg/d for 11 weeks).CHOP,ATF6,and GRP78 mRNA expression was detected by realtime PCR.The clinical efficacy and adverse reactions rate was compared.Results After treatment,the expression of FBG,2 hPBG,HbA1 c,HOMA-IR,TG,TC,and LDL-C was significantly lower in observation group than that in control group(P<0.05).The 2-△△Ct values of CHOP,ATF6,and GRP78 was significantly lower in observation group than that in control group(P<0.05).The clinic effective rate in observation group was 81.9%(59/72),which was lower than that of 62.5%(45/72)in control group(P<0.05).The adverse reactions rate was 2.8%(2/72)in control group and 4.2%(3/72)in observation group.There was no significant difference between the two groups(P>0.05).Conclusion Liraglutide can inhibit ERS to decrease blood glucose and lipid in T2 DM combined with NAFLD patients,with effectively clinical efficacy and safety.