司美格鲁肽联合达格列净、二甲双胍在肥胖型2型糖尿病合并非酒精性脂肪肝患者中的疗效分析

Efficacy of Smaglutide Combined with Dapagliflozin and Metformin in Pa⁃tients with Obese Type 2 Diabetes Mellitus and Nonalcoholic Fatty Liver Disease

目的 研究司美格鲁肽联合达格列净、二甲双胍在肥胖型2型糖尿病(Type 2 Diabetes Mellitus, T2DM)合并非酒精性脂肪肝(Non-alcoholic Fatty Liver, NAFLD)患者中的疗效。方法 选取2021年6月—2023年6月安徽省淮南市寿县人民医院内分泌科收治的80例肥胖型T2DM合并NAFLD患者为研究对象。根据随机数表法分为对照组和观察组,各40例。对照组给予二甲双胍联合达格列净治疗,观察组在对照组基础上联合司美格鲁肽治疗。比较两组治疗12周后的疗效以及药物不良反应发生率。结果 观察组胰岛素抵抗指数、血糖指标、血脂指标、肝功能指标均显著低于对照组,差异有统计学意义(P均<0.05);观察组体质指数为(28.19±0.92)kg/m^(2),低于对照组的(30.12±1.47)kg/m^(2),差异有统计学意义(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论 肥胖型T2DM合并NAFLD患者治疗中,相对于单纯使用达格列净、二甲双胍治疗,联合司美格鲁肽在降低血糖、血脂、肝酶,改善胰岛功能方面效果更优,且不良反应无明显增加。

Objective To study the efficacy of semiglutide combined with dapagliflozin and metformin in patients with obese type 2 diabetes mellitus(T2DM)and non-alcoholic fatty liver disease(NAFLD).Methods A total of 80 obese patients with T2DM combined with NAFLD were selected from the department of endocrinology of Shouxian People's Hospital from June 2021 to June 2023.They were divided into control group and observation group according to ran-dom number table method,40 cases each.The control group received metformin with dagagliflozin,and the observa-tion group was treated with semegallutide on the basis of the control group.Comparing the efficacy and the incidence of adverse drug reactions after 12 weeks of treatment.Results The homa-ir insulin resistance index,blood glucose in-dex,blood lipid index and liver function index were significantly lower than that of the control group,and the differ-ences were statistically significant(all P<0.05).The body mass index in the observation group was(28.19±0.92)kg/m^(2),which was lower than(30.12±1.47)kg/m^(2) in the control group,and the difference was statistically significant(P<0.05).The incidence of adverse reactions was not significant(P>0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion In the treatment of obese T2DM patients with NAFLD,compared with the treatment of dapagliflozin and metformin alone,the combination of semaglu-tide has better effects in reducing blood glucose,blood lipids,liver enzymes,and improving islet function,and there is no significant increase in adverse reactions.