目的:比较西格列汀片与格列美脲片治疗初发2型糖尿病伴非酒精性脂肪肝(NAFLD)的疗效。方法:选取2014年7月~2015年7月间在我院治疗的初发2型糖尿病伴NAFLD患者78例,通过随机数字表法分为观察组及对照组,各39例。对照组在常规治疗的基础上加用格列美脲片,观察组在常规治疗的基础上加用西格列汀片。治疗后对两组患者脂肪肝的疗效进行评价,比较治疗前及治疗12周后两组患者血糖、血脂、肝功能相关指标水平,并观察两组治疗过程中的不良反应。结果:观察组患者总有效率为84.62%,高于对照组的71.49%(P<0.05)。治疗12周后,两组患者血糖、血脂、肝功能相关指标水平均较治疗前改善,且观察谷草转氨酶(AST)、谷丙转氨酶(ALT)、谷氨酰转肽酶(GGT)水平及胰岛素抵抗指数(HOMA-IR)均优于对照组,差异均有统计学意义(均P<0.05)。两组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论:采用西格列汀片治疗初发2型糖尿病伴NAFLD可有效控制患者脂肪肝症状,保护肝功能,相比格列美脲片疗效更好,值得进一步推广使用。 Objective: To compare the efficacy of sitagliptin and glimepiride in the treatment of newly diagnosed type 2 diabetes with non-alcoholic fatty liver disease (NAFLD). Methods: A total of 78 patients with newly diagnosed type 2 diabetes mellitus and NAFLD treated in our hospital from July 2014 to July 2015 were selected and divided into observation group (39 cases) and control group (39 cases) by random number table. The control group on the basis of conventional treatment with glimepiride tablets, the observation group in the conventional treatment based on the addition of sitagliptin tablets. After treatment, the efficacy of fatty liver in both groups was evaluated. The levels of blood glucose, blood lipid and liver function were compared between the two groups before treatment and after 12 weeks of treatment, and the adverse reactions in the two groups were observed. Results: The total effective rate in observation group was 84.62%, which was higher than that in control group (71.49%, P <0.05). After 12 weeks of treatment, the levels of blood glucose, blood lipids and liver function in both groups were improved compared with before treatment, and the levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT), glutamyl transpeptidase (GGT) Resistance index (HOMA-IR) were better than the control group, the differences were statistically significant (P <0.05). Two groups of patients with adverse reactions, the difference was not statistically significant (P> 0.05). CONCLUSIONS: Sitagliptin tablets for the treatment of newly diagnosed type 2 diabetes with NAFLD can effectively control the symptoms of fatty liver and protect the liver function. Compared with glimepiride tablets, it is more effective and worthy of further promotion.