二甲双胍对非酒精性脂肪肝患者肝脏组织学及超声影像学的影响

Influence of Metformin on Liver Histology and Ultrasonography in Patients with Non- Alcoholic Fatty Liver

目的探讨二甲双胍对非酒精性脂肪肝(NAFLD)患者肝脏组织学及超声影像学的影响。方法将118例患者随机分为对照组和观察组,各59例。两组患者均给予健康教育,对照组患者给予阿托伐他汀治疗,观察组患者在对照组治疗基础上加用二甲双胍,疗程均为8周。结果治疗后,观察组患者空腹血糖、胰岛素水平及胰岛素抵抗指数均较前明显下降(P<0.05);两组患者炎症评分均较治疗前明显下降,且观察组下降程度更明显(P<0.05);仅观察组纤维化指标评分较治疗前有明显下降(P<0.05),其肝脏肋下斜径较治疗前明显减小(P<0.05);两组患者治疗过程中药品相关不良反应发生情况无明显差异(P>0.05)。结论二甲双胍能有效减轻NAFLD患者的胰岛素抵抗,对减轻肝细胞炎性反应和预防纤肝维化有明显作用,也能有效防止肝脏体积的增大,且不良反应较低,安全性良好。

Objective To investigate influence of metformin on liver bistology and ultrasonograpby in patients witb non-alcobolic fatty liver disease（NAFLD）. Methods Totally 118 patients witb NAFLD were randomly divided into control group and observation group,59 cases in eacb group. Two groups of patients were giver bealtb education,on tbis basis tbe control group were treated witb atorvastatin, tbe observation group on tbe basis of control group were added metformin,tbe treatment course was 8 weeks. Results After treatment, tbe FPG,insulin levels and insulin resistance index in tbe observation group were significantly decreased tban before treatment（ P 〈0. 05）;tbe inflammatory scores in tbe two groups were significantly decreased tban before treatment,moreover tbe observation group de-creased more significantly（ P 〈 0. 05）;bowever,compared witb before treatment,only in tbe observation group tbe fibrosis score were significantly decreased（ P 〈 0. 05）,tbe liver subcostal oblique diameter was significantly reduced（ P 〈 0. 05）;tbe occurrence rate of adverse drug reactions during tbe treatment course bad no significant difference between tbe two groups（ P 〉0. 05）. Conclusion Met-formin can effectively reduce insulin resistance in patients witb NAFLD,reduce tbe inflammatory response of liver cells and prevent fi-brosis,and can effectively prevent tbe increase of tbe liver volume witb less adverse reactions and good safety.