应用磁共振氢谱技术评价中药肝脂消胶囊治疗非酒精性脂肪肝的疗效

Application of proton magnetic resonance spectroscopy for evaluating the therapeutic effects of Ganzhixiao Capsules in treating nonalcoholic fatty liver disease

摘要目的：应用磁共振氢谱（1H-MRS）技术定量评价复方中药肝脂消胶囊治疗非酒精性脂肪肝（NAFLD）的疗效．方法：依中华医学会NAFLD诊断标准入选NAFLD患者22例，并与20例健康人对照．两组均进行常规体检，包括体质量指数（BMI）、腰臀比（WHR）、血压（BP）、血清谷丙转氨酶（ALT）、空腹血糖（FBG）、胆固醇（TC）、三酰甘油（TG）、尿酸（UA）和肝脏1H-MRS扫描，计算肝内脂质含量（IHCL）．NAFLD组患者服用肝脂消胶囊8wk，检测治疗前后血清生化指标和IHCL的变化．结果：NAFLD组BMI，WHR，DBP,ALT,FBG，TG，UA，IHCL分别较正常组Ig-（BMI：28．4±2．4vs21．7±2．2，WHR：0．91±0．04vs0．83±0．04．DBP：80±10mmHg vs72±8mmHg．ALT：71．5±24．8U／L vs20．4±10．1U／L．FBG：5．67±0．61mmol／L vs4．72±0．43mmol／L．TG：2．48±1．46mm01／Lvs1．05±0．40mmol／L．UA：420．7±57．5gmol／Lvs372．1±50．6μmol／L．IHCL：27．49％±12．27％vs1．34％±0．79％．P〈0．05或P〈0．01）明显升高，但IHCL和上述指标之间没有明显相关性．经治疗后ALT（54．6±19．9U／L，P〈0．01），TG（2．14±1．38mmol／L，P〈0．05），IHCL（19．7％±12．7％，P〈0．01）均明显下降．结论：肝脏1H-MRS扫描可对肝脏内脂质含量进行准确定量，肝脂消胶囊可有效治疗NAFLD．

AIM： To investigate the application of proton magnetic resonance spectroscopy （1H-MRS） for evaluating the therapeutic effects of Ganzhixiao Capsules in treating nonalcoholic fatty liver disease （NAFLD）.METHODS： Twenty-two patients were selected according to the Chinese Medical Association＇s （CMA） criteria for NAFLD and compared with 20 healthy persons （control group）. Body mass index （BMI）, waist to hip ratio （WHR）, and blood pressure （BP） were examined. The serum hepatic enzyme activity （ALT）, the concentration of fasting blood glucose （FBG）, total cholesterol （TC）, triglyceride （TG）, and uric acid （UA） were tested simultaneously. The severity of hepatos- teatosis was evaluated by 1H-MRS scans of the liver, and the intrahepatic content of lipid （IHCL） was measured. Patients in the NAFLD group were treated with Ganzhixiao Capsules for eight weeks. All the above parameters were retested after treatment. RESULTS： The BMI, WHR, serum ALT activity, serum concentration of FBG, TG, UA and IHCL were all significantly elevated in the NAFLD group （BMI： 28.4 ± 2.4, WHR： 0.91 ± 0.04, DBP： 80 ± 10 mmHg, ALT： 71.5 ± 24.8 U/L, FBG： 5.67 ± 0.61 mmol/L, TG： 2.48 ± 1.46 mmol/L, UA： 420.7 ± 57.5 μmol/L, IHCL： 27.49% ± 12.27%, P 〈 0.05 or P 〈 0.01） compared with the control group （BMI： 21.7 ± 2.2, WHR： 0.83 ± 0.04, DBP： 72 ± 8 mmHg, ALT： 20.4 ± 10.1 U/L, FBG： 4.72 ± 0.43 mmol/L, TG： 1.05 ± 0.40 mmol/L, UA： 372.1 ± 50.6 μmol/L, IHCL： 1.34% ± 0.79%, respectively）. However, there was no correlation between clinical features and IHCL. After eight weeks treatment, serum ALT （54.6 ± 19.9 U/L, P 〈 0.01）, TG （2.14 ± 1.38 mmol/L, P 〈 0.05） and IHCL （19.7% ± 12.7%, P 〈 0.01） decreased significantly. CONCLUSION： The intrahepatic content of lipid can be precisely measured by 1H-MRS, and NAFLD can be treated effectively by Ganzhixiao Capsules.