摘要
目的 观察安达释联合盐酸吡格列酮片治疗 2 型糖尿病(T2DM)合并代谢相关脂肪性肝病(MAFLD)的疗效.方法 2023 年 12 月至 2024 年 4 月东莞康华医院 110 例T2DM合并MAFLD患者分别使用安达释(对照组)或安达释联合盐酸吡格列酮(观察组)治疗,比较两组胰岛功能、血糖、血脂、炎症因子、肝脏指标和不良反应.结果 与对照组相比,观察组胰岛素β细胞抵抗指数、总胆固醇、甘油三酯、肿瘤坏死因子-α、白介素-1β、超敏C反应蛋白、丙氨酸氨基转移酶、天门冬氨酸基转移酶、血糖、糖化血红蛋白水平及肝脏硬度、肝脏脂肪含量明显降低,而胰岛素β细胞分泌功能指数则明显升高(P<0.01 或 0.05).两组不良反应总发生率差异无统计学意义(P>0.05).结论 安达释联合盐酸吡格列酮片既可改善T2DM合并MAFLD患者的胰岛功能、血脂、肝功能和血糖水平,又可降低炎症因子、肝脏硬度和肝脏脂肪含量.
Abstract
Objective To observe the therapeutic effect of dapagliflozin/metformin and pioglitazone in type 2 diabetes mellitus(T2DM)with metabolic-associated fatty liver disease(MAFLD).Methods A total of 110 patients with T2DM and MAFLD in Dongguan KangHua Hospital from December 2023 to April 2024 were treated with dapagliflozin/metformin(control group)or dapagliflozin/metformin plus pioglitazone(observation group).The islet function,blood glucose,blood lipid,inflammatory factors,liver indexes and adverse reactions were compared between two groups.Results Compared with control group,islet β resistance index,total cholesterol,triglyceride,tumor necrosis factor-α,interleukin-1β,hypersensitive C-reactive protein,alanine/aspartate aminotransferases,blood glucose,glycosylated hemoglobin,liver stiffness and liver fat content were significantly decreased,while islet β secretion function index increased in observation group(P<0.01 or 0.05).There was no significant difference in the overall incidence of adverse reactions between two groups(P>0.05).Conclusion The combined use of dapagliflozin/metformin and pioglitazone can not only improve the islet function,blood lipid,liver function and blood glucose,but also reduce inflammatory factors,liver stiffness and liver fat content in T2DM patients with MAFLD.
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