利拉鲁肽联合达格列净治疗2型糖尿病合并NAFLD的临床效果

Clinical Effect of Liraglutide Combined with Dagliprazin in the Treatment of Type 2 Diabetes Mellitus with NAFLD

目的:探讨利拉鲁肽联合达格列净对2型糖尿病(T2DM)合并非酒精性脂肪肝病(NAFLD)患者肝功能、肝脏脂肪沉淀及氧化应激的影响。方法:选取2019年1月—2023年6月于九江市柴桑区人民医院住院的T2DM合并NAFLD患者104例,按照随机数字表法分为病例组和对照组,每组52例。对照组给予达格列净治疗,病例组给予达格列净和利拉鲁肽治疗。观察两组患者肝脏脂肪沉淀及氧化应激等的变化。结果:治疗后,两组空腹血糖(FBG)、糖化血红蛋白(HbA1c)、胰岛素抵抗指数(HOMA-IR)、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、谷氨酰转肽酶(GGT)、碱性磷酸酶(ALP)、丙二醛(MDA)、胱抑素C(Cys C)、体重指数(BMI)、腰围、脂肪受控衰减参数、肝脏硬度指数均低于治疗前,空腹胰岛素(FINS)、高密度脂蛋白胆固醇(HDL-C)、超氧化物歧化酶(SOD)、总抗氧化能力(TAOC)、肝/脾CT比值水平均高于治疗前,差异均有统计学意义(P<0.05);治疗后,病例组血糖和胰岛素指标、血脂、肝功能、氧化应激、体征指标、肝脏沉淀改善均优于对照组,差异均有统计学意义(P<0.05)。病例组不良反应发生率虽低于对照组,但差异无统计学意义(P>0.05)。结论:利拉鲁肽联合达格列净可以改善T2DM合并NAFLD患者血糖和肝功能水平,调节氧化应激和血脂,降低肝脏脂肪沉淀,安全性较好。

Objective:To investigate the effects of Liraglutide combined with Dagliprazin on liver function,liver fat precipitation and oxidative stress in type 2 diabetes mellitus(T2DM)patients with non-alcoholic fatty liver disease(NAFLD).Method:A total of 104 patients with T2DM combined with NAFLD who were hospitalized in Chaisang District People's Hospital of Jiujiang City from January 2019 to June 2023 were selected.According to random number table method,the patients were divided into case group and control group,with 52 cases in each group.The control group was treated with Dagliprazin,and the case group was treated with Dagliprazin and Liraglutide.The changes of liver fat precipitation and oxidative stress were observed between the two groups.Result:After treatment,fasting blood glucose(FBG),glycated hemoglobin(HbA1c),insulin resistance index(HOMA-IR),total cholesterol(TC),triglycerides(TG),low-density lipoprotein cholesterol(LDL-C),alanine aminotransferase(ALT),aspartate aminotransferase(AST),glutamyl transpeptidase(GGT),alkaline phosphatase(ALP),malondialdehyde(MDA),cystatin C(Cys C),body mass index(BMI),waist circumference,controlled fat attenuation parameters,liver hardness index in both groups were lower than those before treatment,and the levels of fasting insulin(FINS),high-density lipoprotein cholesterol(HDL-C),superoxide dismutase(SOD),total antioxidant capacity(TAOC),and liver/spleen CT ratio in both groups were higher than those before treatment,the differences were statistically significant(P<0.05);after treatment,blood glucose and insulin indexes,blood lipids,liver function,oxidative stress,physical signs and liver precipitation in the case group were better than those in the control group,the differences were statistically significant(P<0.05).Although the incidence of adverse reactions in case group was lower than that in control group,but the difference was not statistically significant(P>0.05).Conclusion:Liraglutide combined with Dagliprazin can improve blood glucose and liver function,regulate oxidative stress and lipid,and reduce liver fat precipitation in T2DM patients with NAFLD,with good safety.