恩格列净对乙型病毒性肝炎合并T2DM患者的疗效与安全性

Effect and safety analysis of empagliflozin combined with insulin therapy in patients with virus B hepatitis combined with T2DM

目的:分析恩格列净在乙型病毒性肝炎合并2型糖尿病(T2DM)患者中应用疗效及其安全性。方法:选择在某医院就诊的42例乙型病毒性肝炎合并T2DM患者,随机平分为观察组和对照组。观察组给予恩格列净联合胰岛素降糖,对照组单纯使用胰岛素降糖,观察两组治疗效果及安全性。结果:治疗前,两组各项指标无明显差异(P>0.05)。治疗3 mon后,两组BMI、腰围、空腹胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)、总胆固醇(TC)、甘油三酯(TG)等有明显差异(P<0.05),且观察组每日胰岛素用量明显低于对照组(P<0.05),但两组间谷丙转氨酶(ALT)、谷草转氨酶(AST)、血清白蛋白(Alb)、总胆红素(TBiL)、乙肝病毒DNA定量(HBV-DNA)、肝脏纤维化指标等无明显差异(P>0.05)。治疗后,观察组BMI、腰围、FBC、HbA1c、FINS、HOMA-IR、TC、高密度胆固醇(HDL)均较治疗前明显改善(P<0.05),而ALT、AST、Alb、TBiL、HBV-DNA、肝脏纤维化指标等较治疗前无显著差异(P>0.05)。结论:恩格列净可明显改善乙型病毒性肝炎合并T2DM患者胰岛功能,减轻胰岛素抵抗,且不增加患者体重并有辅助降脂作用,但未观察到有改善肝纤维化的作用。恩格列净对此类患者是安全的,无严重不良反应发生。

Objective:To evaluate the efficacy and safety of empagliflozin in patients with hepatitis B virus combined with type 2 diabetes mellitus(T2 DM).Methods:42 patients with hepatitis B virus combined with T2 DM were randomly divided into two groups:observation group and control group.The observation group used empagliflozin and insulin to control blood sugar,as the contrast group only used insulin.The efficacy and safety of the two groups were observed.Results:All the observation projects had no significant difference between the two groups before the treatment(P> 0.05).After 3 months of treatment,there were significant differences between the two groups in BMI,waist,fasting insulin(FINS),insulin resistance index(HOMA-IR),total cholesterol(TC) and triglyceride(TG)(P <0.05),and the daily dose of insulin was significantly lower in the observation group than in the control group(P<0.05).However,there was no significant difference between the two groups in serum alanine aminotransferase(ALT),aspartate aminotransferase(AST),serum albumin(Alb),total bilirubin(TBiL),hepatitis B virus DNA(HBV-DNA) and liver fibrosis index(P>0.05).The BMI,waist,FBG,HbA1 C,FINS,HOMA-IR,TC,and high-density cholesterol(HDL) of observation group were all significantly improved after treatment(P <0.05),but there were no significant differences in ALT、AST,Alb,TBiL,HBV-DNA and liver fibrosis indicators after the treatment(P> 0.05).Conclusion:Empagliflozin can significantly improve the islet function,reduce insulin resistance,and do not increase the weight of patients and have a lipid-lowering effect on patients with hepatitis B virus combined with T2 DM,but there is no clear improvement in liver fibrosis.Empagliflozin is safe for such patients and does not have serious adverse effects.