非诺贝特联合胰岛素治疗2型糖尿病合并非酒精性脂肪性肝病患者疗效观察

Effect of fenofibrate combined with insulin in the treatment of type 2 diabetes mellitus complicated with nonalcoholic fatty liver disease

目的对比研究非诺贝特联合胰岛素治疗2型糖尿病(TYPE 2)合并非酒精性脂肪性肝病患者疗效及对肝功能、血糖含量和血管内皮功能的影响。方法回顾性分析本院收治的150例TYPE 2合并非酒精性脂肪性肝病患者的临床资料及随访资料,根据治疗方法的不同将其分为对照组(n=70)和观察组(n=80),对照组患者接受健康饮食、合理运动等指导,并予以胰岛素治疗,观察组在对照组基础上加入非诺贝特治疗,两组均治疗3个月。分别比较两组临床疗效、治疗前后肝功能、血糖含量及血管内皮功能的水平变化。结果观察组与对照组临床有效率分别为92.50%、75.71%(P<0.05);较治疗前相比,两组治疗后ALT、AST、FPG、2hPG、HbA1c均有所下降(P<0.05),且观察组下降幅度大于对照组(P<0.05);较治疗前相比,两组治疗后ET、TXB2均有所下降(P<0.05),PGF1、NO明显上升(P<0.05),且观察组改善程度明显大于对照组(P<0.05)。结论采用非诺贝特联合胰岛素治疗TYPE 2合并非酒精性脂肪性肝病患者临床治疗疗效显著,可改善患者肝功能,降低血糖水平,改善血管内皮功能,值得临床上进一步推广。

Objective To compare the effect of fenofibrate combined with insulin in the treatment of type 2 diabetes mellitus(T2DM)complicated with nonalcoholic fatty liver disease and its influence on liver function,blood glucose content and vascular endothelial function.Methods The clinical data and follow-up data of 150 patients with type 2 complicated with nonalcoholic fatty liver disease were analyzed retrospectively,they were divided into control group(n=70)and observation group(n=80)according to the random number method.The patients in the control group received the guidance of healthy diet and reasonable exercise,and received insulin treatment.The observation group was treated with fenofibrate on the basis of the control group,and both groups were treated for 3 months.The clinical efficacy,liver function,blood glucose content and vascular endothelial function before and after treatment were compared between the two groups.Results The clinical effective rates of the observation group and the control group were 92.50%and 75.71%(P<0.05);compared with those before treatment,ALT,AST,FPG,2hPG,HbA1c in the two groups were decreased after treatment(P<0.05),and the decline in the observation group was greater than that in the control group(P<0.05).After treatment,ET and TXB2 in the two groups were decreased(P<0.05),and PGF1 and NO were significantly increased(P<0.05)in the observation group.The improvement degree was significantly greater than that in the control group(P<0.05).Conclusion Fenofibrate combined with insulin in the treatment of T2DM patients with nonalcoholic fatty liver disease has significant clinical curative effect,which can improve renal function,reduce blood glucose level and improve vascular endothelial function,which is worthy of further clinical promotion.