恩格列净和吡格列酮治疗2型糖尿病合并非酒精性脂肪肝的效果比较

Comparison on effect of empagliflozin versus pioglitazone on type 2 diabetes mellitustype complicated by non-alcoholic fatty liver disease

目的比较恩格列净和吡格列酮治疗2型糖尿病合并非酒精性脂肪肝的效果。方法抽取2018年1月至2020年1月郑州颐和医院收治的60例2型糖尿病合并非酒精性脂肪肝患者为研究对象,按照随机数字表法分为对照组和观察组,每组30例。两组均给予二甲双胍进行治疗,在此基础上,对照组使用吡格列酮治疗,观察组使用恩格列净治疗。比较两组的治疗效果及不良反应发生率,比较两组治疗前后体质指数(BMI)、腰臀比及血糖、血脂指标[总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)]、肝功能指标[丙氨酸氨基转移酶(ALT)、谷氨酰转移酶(GGT)]。结果观察组治疗有效率(90.00%,27/30)高于对照组(66.67%,20/30),P<0.05。治疗后,观察组BMI和腰臀比低于其治疗前(P<0.05),且腰臀比低于对照组(P<0.05)。治疗后,两组血糖、血脂指标及肝功能指标与治疗前比较差异均有统计学意义(P均<0.05),且观察组BMI、腰臀比、糖化血红蛋白、胰岛素抵抗指数及TC、TG、LDL-C、ALT、GGT水平均低于对照组(P均<0.05),HDL-C水平高于对照组(P<0.05)。观察组不良反应发生率(6.67%,2/30)与对照组(10.00%,3/30)比较差异未见统计学意义(P>0.05)。结论2型糖尿病合并非酒精性脂肪肝患者在服用二甲双胍基础上,联合恩格列净或吡格列酮均可有效控制患者血糖、血脂水平及脂肪肝程度,改善肝功能,用药安全性理想,且恩格列净的效果更佳。

Objective To compare the effects of empagliflozin and pioglitazone on type 2 diabetes mellitus complicated by non-alcoholic fatty liver disease.Methods Sixty patients with type 2 diabetes mellitus complicated by non-alcoholic fatty liver disease admitted to Zhengzhou Yihe Hospital from January 2018 to January 2020 were selected as the research subjects,and they were divided into control group and observation group by random number table method,with 30 cases in each group.Both groups were treated with metformin at the same time.On this basis,the control group was treated with pioglitazone,and the observation group was treated with englitazone.The therapeutic effect and incidence of adverse reactions were compared between the two groups.The body mass index(BMI),waist hip ratio,blood glucose and blood lipid indexes including total cholesterol(TC),triacylglycerol(TG),high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),liver function assessed by alanine aminotransferase(ALT)and glutamyltransferase(GGT)were compared between the two groups before and after treatment.Results The effective rate of the observation group(90.00%,27/30)was higher than that of the control group(66.67%,20/30),P<0.05.After treatment,the BMI and waist hip ratio of the observation group were lower than those before treatment(P<0.05),and the waist hip ratio of the observation group was lower than that of the control group(P<0.05).There were significant differences in preoperative and postoperative blood glucose,blood lipid and liver function in the two groups(all P<0.05);moreover,BMI,waist hip ratio,glycosylated hemoglobin,insulin resistance index,the levels of TC,TG,LDL-C,ALT and GGT in the observation group were lower than those in the control group(all P<0.05),while the levels of HDL-C were higher than those in the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the observation group(6.67%,2/30)and the control group(10.00%,3/30),P>0.05.Conclusions For patients with type 2 diabetes mellitus complicated by non-alcoholic fatty liver disease,both metformin combined with englicin and combined with pioglitazone can effectively control blood glucose,blood lipid levels and degree of fatty liver,and improve liver function,with ideal drug safety.And the effect of englitazin is better.