多烯磷脂酰胆碱联合生活方式干预治疗非酒精性脂肪性肝炎临床观察

Clinical observation of polyene phosphatidylcholine combined with lifestyle intervention in treatment of patients with non-alcoholic steatohepatitis

目的观察多烯磷脂酰胆碱联合生活方式干预治疗非酒精性脂肪性肝炎(NASH)的临床疗效。方法 82例NASH患者被随机分为观察组42例和对照组40例。对照组口服多烯磷脂酰胆碱胶囊456mg,3次/d;观察组在对照组基础上进行生活方式干预,即健康教育、饮食控制和运动,两组均观察6个月。观察两组治疗前后肝功能、血脂、空腹血糖(FPG)、人体质量指数(BMI)及肝脏B超的影像学变化。结果观察组治疗后AST、ALT和GGT分别为(35.8±14.5)U/L、(41.5±12.5)U/L和(46.5±17.0)U/L,血TG和HDL分别为(1.8±0.9)mmol/L和(1.5±0.6)mmol/L,FPG和BMI分别为(5.2±0.5)mmol/L和(27.8±2.4)kg/m2;对照组AST、ALT和GGT分别为(49.6±18.2)U/L、(56.8±21.6)U/L和(65.2±27.5)U/L,TG和HDL分别为(2.3±1.1)mmol/L和(1.2±0.4)mmol/L,FPG和BMI分别为(5.7±0.6)mmol/L和(28.9±2.5)kg/m2,与治疗组比,差异均有统计学意义(P<0.05或P<0.01);观察组治疗后B超检查发现脂肪肝分度变化较治疗前和对照组均有明显改善(U=4.52、U=3.15,P<0.01),而对照组治疗前后差异无统计学意义。结论饮食控制和运动干预对非酒精性脂肪性肝炎治疗有重要的作用,可明显改善患者肝功能、血脂、空腹血糖、人体质量指数和B超检查指标。

Objective To investigate the effect of polyene phosphatidylcholine combined with lifestyle inter-vention in treatment of patients with non-alcoholic steatohepatitis （NASH）. Methods Eighty-two patients with NASH were randomly divided into observation group（n=42）and control group（n=40）. The patients in control group were treated with polyene phosphatidylcholine capsules at dose of 456 mg three times daily,while in the observa-tion group lifestyle intervention including healthy dietary education and sports was added. Patients were all treated for 6 months. Before and after treatment,liver function,blood lipids,fasting plasma glucose （FPG）,body-mass index and changes of liver under ultrasound imaging in the two groups were monitored. Results At the end of treat-ment,serum AST,ALT and GGT levels in the observation group were （35.8±14.5）U/L,（41.5±12.5）U/L and （46.5± 17.0）U/L,respectively. Blood TG and HDL were（1.8±0.9）mmol/L and （1.5±0.6）mmol/L,respectively. FPG and BMI were（5.2±0.5）mmol/L and（27.8±2.4）kg/m2,respectively;In the control group,AST,ALT and GGT were（49.6± 18.2）U/L,（56.8±21.6）U/L and （65.2±27.5）U/L,respectively. TG and HDL were（2.3±1.1）mmol/L and （1.2±0.4） mmol/L,respectively. FPG and BMI were（5.7±0.6）mmol/L and （28.9±2.5）kg/m2,respectively. The differences be-tween the two groups were all statistically significant （P〈0.05 or P〈0.01）;Liver ultrasound imaging in the observa-tion group improved significantly than that before treatment and that in the control group（U=4.52,U=3.15,P〈0.01）. No significant difference was found in control group before and after treatment. Conclusion Diet controls and sports have significant therapeutic effects on non-alcoholic steatohepatitis by improving liver function,blood lipid, FPG,BMI and liver ultrasound imaging.