摘要
非酒精性脂肪性肝病(NAFLD)已成为国内外常见慢性肝脏疾病之一,由于胰岛素抵抗在NAFLD发病机制中的重要作用,胰岛素增敏剂逐渐成为有前景的NAFLD治疗药物。本文分析总结了近年来胰岛素增敏剂治疗NAFLD的文献,结果提示,吡格列酮(PGZ)、罗格列酮(RGZ)和二甲双胍(MF)均能改善NAFLD患者肝酶水平和胰岛素抵抗;在改善肝脏组织学方面,PGZ有随机双盲对照研究证据的支持,显示出良好的应用前景;而MF与RGZ,缺少有力的人体研究支持。大多数研究中患者可以耐受胰岛素增敏剂,未见明显不良反应。目前已有研究的样本量均不大,疗程大多不超过2年,因此,仍需要设计良好的临床试验来进一步评价胰岛素增敏剂对NAFLD的疗效和安全性。
Nonalcoholic fatty liver disease ( NAFLD ) has become one of the most common liver diseases in the world. Considering the important role of insulin resistance in its pathogenic mechanisms,insulin sensitizers are becoming the promising pharmacological strategies for NAFLD. We collected and analyzed the relevant articles in recent years and found that pioglitazone,rosiglitazone and metformin could improve liver enzymes and insulin sensitivity of NAFLD. However, only pioglitazinc was supported in ameliorating liver histology by envidences from randomized, double-blinded, controlled clinical trials. There were no much obvious adverse effects in NAFLD patients who received insulin senitizers. Small or medium samples and no more than 2 years of treatment course may be the major limitation of current studies. Future information derived from well- designed running trials will be useful in defining the clinical implications of insulin sensitizers in the treatment of NAFLD.
出处
《中国实用内科杂志》
CAS
CSCD
北大核心
2009年第5期405-409,共5页
Chinese Journal of Practical Internal Medicine