目的 探究瑞舒伐他汀鈣片聯(lián)合鹽酸二甲雙胍片對2型糖尿病并發(fā)非酒精性脂肪性肝病患者的肝功能指標(biāo)、炎癥因子水平及生化指標(biāo)的影響。方法 選擇延安市人民醫(yī)院于2017年10月—2018年10月收治的2型糖尿病并發(fā)非酒精性脂肪性肝病患者600例，根據(jù)其入院順序隨機(jī)均分為兩組，每組各300例。對照組給予患者鹽酸二甲雙胍片進(jìn)行治療，500 mg/次，2次/d。觀察組在對照組基礎(chǔ)上聯(lián)合瑞舒伐他汀鈣片進(jìn)行治療，10 mg/次，1次/d。兩組均持續(xù)治療2個月。對比兩組的肝功能指標(biāo)、炎癥因子水平及生化指標(biāo)。結(jié)果 治療后，兩組的丙氨酸氨基轉(zhuǎn)移酶（ALT）、門冬氨酸氨基轉(zhuǎn)移酶（AST）、堿性磷酸酶（ALP）、谷氨酰轉(zhuǎn)肽酶（GGT）等肝功能指標(biāo)均比治療前顯著降低（P<0.05）；且觀察組顯著低于對照組（P<0.05）。治療后，兩組的白介素-6（IL-6）、腫瘤壞死因子-α（TNF-α）、C反應(yīng)蛋白（CRP）等炎癥因子水平均比治療前顯著降低（P<0.05），且觀察組顯著低于對照組（P<0.05）。治療后，兩組的同型半胱氨酸（Hcy）、胱抑素C（CysC）、豬硫氧還蛋白相互作用蛋白（TXNIP）均比治療前顯著降低（P<0.05），且觀察組顯著低于對照組（P<0.05）；而Nesfatin-1水平均比治療前顯著升高（P<0.05），且觀察組顯著高于對照組（P<0.05）。結(jié)論 瑞舒伐他汀鈣片聯(lián)合鹽酸二甲雙胍片可有效改善2型糖尿病并發(fā)非酒精性脂肪性肝病患者的肝功能指標(biāo)和抑制炎癥反應(yīng)，并調(diào)節(jié)患者血清Nesfatin-1等生化指標(biāo)水平，臨床應(yīng)用效果顯著。

Objective To investigate the effects of Rosuvastatin Calcium Tablets combined with Metformin Hydrochloride Tablets on liver function, inflammatory factors and biochemical parameters in patients with type 2 diabetes mellitus (T2DM) complicated with nonalcoholic fatty liver disease (NAFLD). Methods Patients (600 cases) with T2DM complicated with NAFLD admitted to Yan'an People's Hospital from October 2017 to October 2018 were enrolled. They were divided into two groups according to the order of admission, and each group had 300 cases. Patients in the control group were treated with Metformin Hydrochloride Tablets, 500 mg/time, twice daily. Patients in the observation group were treated with Rosuvastatin Calcium Tablets on the basis of control group, 10 mg/time, once daily. Patients in two groups were treated for 2 months. After 2 months of treatment, the liver function indexes, inflammatory factor levels and biochemical indicators were compared between two groups. Results After treatment, the liver function indexes of ALT, ALP, AST and GGT were significantly lower than those before treatment (P < 0.05), and the indexes in the observation group was significantly lower than those in the control group (P < 0.05). After treatment, the levels of IL-6 and TNF-α, and CRP in two groups were significantly lower than those before treatment (P < 0.05), and the inflammatory factors levels in the observation group was significantly lower than those in the control group (P < 0.05). After treatment, the levels of Hcy, CysC, and TXNIP in two groups were significantly decreased (P < 0.05), and the indexes in the observation group was significantly lower than those in the control group (P < 0.05). And the ratio of Nesfatin-1 in two groups were significantly increased (P < 0.05) the Nesfatin-1 in the observation group was significantly higher than those in the control group (P < 0.05). Conclusion Rosuvastatin Calcium Tablets combined with Metformin Hydrochloride Tablets can effectively improve the liver function indexes and inhibit the inflammatory response in patients with T2DM complicated with NAFLD, and regulate the serum levels of Nesfatin-1 and other biochemical indicators. The clinical application effect is significant.

R977

陜西省科協(xié)企業(yè)創(chuàng)新爭先青年人才托舉計劃項目（20180308）