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目的观察艾塞那肽对T2DM合并非酒精性脂肪性肝病(NAFLD)患者血糖、体重和肝酶学指标的治疗效果。方法 T2DM合并NAFLD患者117例,随机分为艾塞那肽组和二甲双胍组,治疗12周,观察体重、血糖、血脂、胰岛素抵抗指数(HOMA-IR)、肝酶学指标、脂联素(APN)及高敏C反应蛋白(hsC-RP)的变化。结果与二甲双胍组相比,艾塞那肽组体重[(76.09±9.85)vs(77.22±10.15)kg]、WHR[(0.94±0.05)vs(0.96±0.04)]、谷丙转氨酶[(39.82±14.05)vs(51.48±18.89)U/L]、谷草转氨酶[(25.61±7.87)vs(31.54±10.75)U/L]、谷氨酰转肽酶[(47.53±15.80)vs(53.44±15.00)U/L]和hsC-RP[(2.18±0.34)vs(2.69±0.53)mg/L]明显降低(P<0.05或P<0.01);APN水平[(10.44±3.29)vs(8.48±2.67)mg/L]明显升高。结论与二甲双胍相比,艾塞那肽用于T2DM合并NAFLD患者在有效控制血糖及降低体重的同时可更好地改善肝酶学指标。
Objective To observe the therapeutic effect of exenatide on blood glucose, body weight and liver enzymology in T2DM patients with non-alcoholic fatty liver disease (NAFLD). Methods A total of 117 T2DM patients with NAFLD were randomly divided into exenatide group and metformin group for 12 weeks. Body weight, blood glucose, blood lipid, insulin resistance index (HOMA-IR), liver enzymology index, adiponectin ) And high-sensitivity C-reactive protein (hsC-RP) changes. Results Compared with metformin group, the weight of exenatide group [(76.09 ± 9.85) vs (77.22 ± 10.15) kg], WHR (0.94 ± 0.05) vs (0.96 ± 0.04) 14.5) vs (51.48 ± 18.89) U / L], aspartate aminotransferase (25.61 ± 7.87 vs 31.54 ± 10.75 U / L), glutamyl transpeptidase (47.53 ± 15.80) vs (53.44 ± 15.00) (10.44 ± 3.29 vs 8.48 ± 2.67, P <0.05 or P <0.01). The level of APN was significantly higher in UA group than that in control group (P <0.05) mg / L] was significantly higher. Conclusion Compared with metformin, exenatide in patients with T2DM and NAFLD can better improve liver enzymatic parameters while effectively controlling blood glucose and reducing body weight.