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116例经CT确诊的NAFL合并(T2DM)患者,随机分成三组:PGT组予吡格列酮15mg,日一次;二甲双胍(Met)组予二甲双胍0.5g,日三次;对照(Con)组予以除二甲双胍及噻唑烷二酮类以外的其他降糖药物治疗,共6个月。结果治疗后PGT组肝脾CT比值、胰岛素敏感指数(ISI)和脂肪肝消失率最高,MeT组次之,Con组最低。PGT组胰岛素抵抗指数(HOMA-IR)最低,Met组次之,Con组最高。PGT组和Met组的空腹胰岛素(Fins)明显低于Con组。结论PGT能够治疗NAFL,增加胰岛素敏感性,改善胰岛素抵抗,疗效优于二甲双胍,对肝功能无明显损害。
One hundred and sixty-six patients with NAFL complicated with T2DM diagnosed by CT were randomly divided into three groups: PGT group treated with pioglitazone 15mg once daily; metformin 0.5g metformin administered three times daily; control group (Con) Alkaloids other than hypoglycemic drugs, a total of 6 months. Results After treatment, the liver-spleen CT ratio, insulin sensitivity index (ISI) and fatty liver disappearance rate were the highest in PGT group, followed by MeT group and lowest in Con group. PGT group insulin resistance index (HOMA-IR) lowest, followed by Met group, Con group highest. Fasting insulin (Fins) in PGT group and Met group was significantly lower than that in Con group. Conclusions PGT can treat NAFL, increase insulin sensitivity and improve insulin resistance. The effect of PGT is superior to that of metformin, and no significant damage to liver function.