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目的临床观察胰岛素增敏剂吡格列酮对2型糖尿病合并非酒精性脂肪肝炎患者治疗的有效性和安全性。方法将55例2型糖尿病合并非酒精性脂肪肝炎患者随机分为两组,吡格列酮组给予吡格列酮30 mg,1次/d,对照组给予除噻唑烷二酮类以外的其他降糖药物治疗,疗程均为24周。比较两组治疗前后指标:空腹血糖、餐后2 h血糖、空腹胰岛素、糖化血红蛋白、胰岛素抵抗指数、天冬氨酸转氨酶、丙氨酸转氨酶、血脂及脂肪肝程度。结果治疗后两组空腹血糖、餐后2 h血糖、糖化血红蛋白均有明显改善,两组比较差异无统计学意义(P>0.05),吡格列酮组在控制空腹血胰岛素、胰岛素抵抗指数水平及改善肝功能、血脂、脂肪肝程度方面,与对照组相比差异均有统计学意义(P<0.05)。结论吡格列酮能增加胰岛素敏感性,在血糖下降的同时,可明显改善肝酶学的异常,胰岛素抵抗和减轻脂肪肝的程度。
Objective To observe the efficacy and safety of insulin sensitizer pioglitazone in the treatment of type 2 diabetes mellitus patients with non-alcoholic steatohepatitis. Methods Fifty-five patients with type 2 diabetes mellitus and non-alcoholic steatohepatitis were randomly divided into two groups. Pioglitazone group was given pioglitazone 30 mg once daily, while the control group was given other anti-thiazolidinedione drugs besides hypoglycemic drugs. The course of treatment All for 24 weeks. Fasting blood glucose, fasting blood glucose, fasting insulin, glycosylated hemoglobin, insulin resistance index, aspartate aminotransferase, alanine aminotransferase, blood lipid and fatty liver were compared between the two groups before and after treatment. Results After treatment, fasting blood glucose, postprandial blood glucose 2 h and HbA1c in both groups were significantly improved. There was no significant difference between the two groups (P> 0.05). In the pioglitazone group, fasting blood insulin and insulin resistance index, Function, blood fat, fatty liver, compared with the control group, the difference was statistically significant (P <0.05). Conclusion Pioglitazone can increase insulin sensitivity, while reducing blood glucose, can significantly improve the abnormal liver enzymes, insulin resistance and reduce the degree of fatty liver.