艾塞那肽联合二甲双胍治疗对2型糖尿病合并NAFLD患者胰岛素抵抗、肝功能及炎症反应的效应

摘要

目的:探讨艾塞那肽联合二甲双胍治疗对2型糖尿病合并非酒精性脂肪肝(NAFLD)患者胰岛素抵抗、肝功能及炎症反应的影响.方法:收集2015年2月～2017年1月间在本院接受治疗的2型糖尿病合并NAFLD患者98例,经随机数表法分为对照组及观察组,各49例.对照组患者接受二甲双胍治疗,观察组患者接受艾塞那肽联合二甲双胍治疗.治疗前、治疗12周后,检测两组患者血清中的胰岛素抵抗指标、肝功能指标、炎症因子水平.结果:治疗前,两组患者血清中胰岛素抵抗指标、肝功能指标、炎症因子的水平无显著性差异;治疗12周后,观察组患者血清中胰岛素(INS)、胰岛素抵抗指数(HO-MA-IR)的水平以及天冬氨酸草转氨酶(AST)、丙氨酸转氨酶(ALT)、谷氨酰转肽酶(GGT)、碱性磷酸酶(ALP)、超敏C反应蛋白(hs-CRP)、白介素-1β(IL-1β)、白介素-6(IL-6)的含量低于对照组患者.结论:2型糖尿病合并NAFLD患者接受艾塞那肽联合二甲双胍治疗,可有效减轻胰岛素抵抗并减轻肝功能损伤,抑制全身炎症反应.%Objective:To study the effect of exenatide combined with metformin therapy on insulin resistance,liver function and inflammatory response in patients with type 2 diabetes mellitus combined with NAFLD.Methods:A total of 98 patients with type 2 diabetes mellitus combined with NAFLD who were treated in the hospital between February 2015 and January 2017 were divided into control group and observation group by random number table,each with 49 cases.Control group received metformin therapy,and observation group received exenatide combined with metformin therapy.Serum levels of insulin resistance indexes,liver function indexes and inflammatory factors of two groups of patients were detected before treatment and after 12 weeks of treatment.Results:Before treatment,serum levels of insulin resistance indexes,liver function indexes and inflammatory factors were not significantly different between the two groups of patients;after 12 weeks of treatment,serum INS and HOMA-IR levels as well as AST,ALT,GGT,ALP,hs-CRP,IL-1β and IL-6 contents of observation group were lower than those of control group.Conclusion:Exenatide combined with metformin therapy can effectively reduce insulin resistance,reduce liver function injury and inhibit systemic inflammatory response in patients with type 2 diabetes mellitus combined with NAFLD.