达格列净结合利拉鲁肽对2型糖尿病合并非酒精性脂肪性肝病的CRP,D二聚体及肝功能的影响

Effects of Dapagliflozin Combined with Liraglutide on CRP,D-dimer and Liver Function in Patients with Type 2 Diabetes Mellitus Complicated with Nonalcoholic Fatty Liver Disease

目的研讨达格列净结合利拉鲁肽对2型糖尿病(T2DM)合并非酒精性脂肪性肝病(NAFLD)患者血清中的肝功能指标、炎性指标C反应蛋白(CRP)水平及凝血功能指标D-二聚体水平的影响。方法选取2020年8月至2022年2月收入我院的T2DM合并NAFLD患者86例,按照随机数表法分为两组,每组43例。对照组予以利拉鲁肽单药治疗,观察组基于对照组条件施加达格列净治疗,疗程12周。比较两组治疗前后的血糖水平[空腹血糖(FBG)、餐后2h血糖(2hPG)]、血清CRP、D-二聚体水平以及肝功能[丙氨酸转氨酶(ALT)、天门冬氨酸转氨酶(AST)、γ-谷氨酰转肽酶(GGT)],并评价其用药安全性。结果观察组治疗后FBG及2hPG测定值均低于对照组,差异有统计学意义(P<0.05)。观察组治疗后血清CRP、D-二聚体水平均低于对照组,差异有统计学意义(P<0.05)。观察组治疗后各肝功能指标(AST、ALT及GGT)均低于对照组,差异有统计学意义(P<0.05)。两组发生低血糖、泌尿系感染等不良反应的患者总占比(观察组为9.30%,对照组为6.68%)比较,差异无统计学意义(P>0.05)。结论对T2DM合并NAFLD患者应用达格列净及利拉鲁肽治疗,能够更有效降低血糖水平,减轻机体高凝状态及炎性反应,改善患者肝功能,且保障用药安全。

Objective To investigate the effects of Dapagliflozin combined with liraglutide on C-reactive protein(CRP),D-dimer and liver function in patients with type 2 diabetes mellitus(T2DM)complicated with nonalcoholic fatty liver disease(NAFLD).Methods 86 patients with T2DM complicated with NAFLD admitted to our hospital from August 2020 to February 2022 were randomly divided into two groups with 43 patients in each group.The control group was treated with liraglutide,and the observation group was treated with Dapagliflozin based on the conditions of the control group,with a course of 12 weeks.The blood glucose levels[fasting blood glucose(FBG),2-hour postprandial blood glucose(2hPG)],serum CRP,D-dimer levels and liver function[alanine transaminase(ALT),aspartic transaminase(AST)andγ-Gamma glutamyl transpeptidase(GGT)],and to evaluate its drug safety.Results After treatment,FBG and 2hPG in the observation group were lower than those in the control group(P<0.05).The levels of serum CRP and D-dimer in the observation group were significantly lower than those in the control group(P<0.05).After treatment,the indexes of liver function(AST,ALT and GGT)in the observation group were lower than those in the control group(P<0.05).There was no significant difference in the total proportion of patients with hypoglycemia,urinary tract infection and other adverse reactions between the two groups(9.30%in the observation group and 6.68%in the control group)(P>0.05).Conclusion The treatment of T2DM patients with NAFLD with Dapagliflozin and liraglutide can effectively reduce blood glucose level,reduce hypercoagulable state and inflammatory reaction,improve liver function and ensure drug safety.