马来酸罗格列酮对2型糖尿病合并非酒精性脂肪肝的疗效观察

目的:评价罗格列酮对2型糖尿病(T2DM)合并非酒精性脂肪肝(NAFL)的作用,观察其疗效。方法:选择32例T2DM合并NAFL患者,在口服磺脲类、双胍类、α-糖苷酶抑制剂基础治疗上加用马来酸罗格列酮,采用治疗前后对照方法,观察空腹血糖(FPG),餐后2h血糖(2hPG),糖化血红蛋白(HbA1C),空腹胰岛素含量(FIns),胰岛素抵抗指数(HOMA-IR),胰岛素敏感指数(ISI),甘油三酯(TG),总胆固醇(TC),高密度脂蛋白(HDL-C),低密度脂蛋白(LDL-C),谷丙转氨酶(GPT),谷草转氨酶(GOT)等变化。并比较治疗前后肝脏彩色多普勒B超影像学改变。结果:加用马来酸罗格列酮治疗后,FPG、2hPG、HbA1C、FIns、HOMA-IR明显降低,ISI升高(P<0.01)。TC、TG、LDL-C、GPT、GOT显著下降(P<0.05),HDL-C变化无统计学意义。B超影像学显示脂肪肝明显减轻。结论:马来酸罗格列酮能改善T2DM合并NAFL患者的血糖和血脂谱,减少胰岛素抵抗,逆转肝脂肪变性和NAFL所致的肝脏酶谱升高。

The Clinical Effects of Rosiglitazone on Type 2 Diabetes Mellitus Combined with Non-alcoholic Fatty Liver

Objective:To observe the clinical effects of rosiglitazone on type 2 diabetes patients combined with non-alcoholic fatty liver(NAFL).Methods:A total of 32 cases of type 2 diabetes mellitus combined with NAFL recieved rosiglitazone on the basis of the therapy of sulphonylurea,biguanides and α-glucosidase inhibitor.To cross-refer the treatment,many measurements were taken,including fasting plasma gloucose(FPG),two-hour postprandial plasma gloucose(2hPG),hemoglobin A1C(HbA1C),fasting insulin(FIns),insulin resistance index(IRI),homeostatic model assessment,insulin sensitive index(ISI),triglyceride(TG),total cholesterol(TC),high density lipoprotein(HDL-C),low density lipoprotein(LDL-C),GPT,GOT and B-ultrasonic of liver.Results:Affer taking rosiglitazone,the levels of FPG,2hPG,HbA1C,FIns and HOMA-IR decreased significantly,the level of ISI increased(P<0.01for all),and the levels of TC,TG, LDL-C,GPT and GOT decreased even more singnificantly(P<0.05 for all).B-ultrasonic examination of liver showed the improvement of fatty liver.Conclusion:Rosiglitazone can ameliorate the plasma gloucose and plasma lipid of the patients with type 2 diabetes combined with NAFL,reduce the insulin resistance,reverse the fatty degeneration of liver and increasing of hepatic enzyme chart induced by NAFL.