熊去氧胆酸联合多烯磷脂酰胆碱治疗非酒精性脂肪性肝病疗效观察

Effect of ursodeoxycholic acid combined with polyene phosphatidylcholine in treatment of non-alcoholic fatty liver disease

目的探讨熊去氧胆酸联合多烯磷脂酰胆碱治疗非酒精性脂肪性肝病(NAFLD)的临床效果。方法 94例NAFLD患者分为观察组和对照组,每组47例。对照组患者给予熊去氧胆酸治疗,观察组患者给予熊去氧胆酸联合多烯磷脂酰胆碱治疗,连续治疗12周后比较2组患者的治疗效果。结果观察组和对照组患者治疗总有效率分别为91.49%(43/47)和70.21%(33/47),观察组患者治疗总有效率显著高于对照组(P<0.05)。治疗前2组患者丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、总胆红素(TBIL)及γ-谷氨酰转肽酶(γ-GT)水平比较差异均无统计学意义(P>0.05);2组患者治疗后ALT、AST、TBIL及γ-GT水平均显著低于治疗前(P<0.05);治疗后观察组患者ALT、AST、TBIL及γ-GT水平均显著低于对照组(P<0.05)。治疗前2组患者总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)及高密度脂蛋白胆固醇(HDL-C)水平比较差异均无统计学意义(P>0.05);2组患者治疗后TC、TG、LDL-C水平显著低于治疗前(P<0.05),HDL-C显著高于治疗前(P<0.05);治疗后观察组患者TC、TG、LDLC水平显著低于对照组(P<0.05),HDL-C显著高于对照组(P<0.05)。治疗期间,观察组患者出现腹泻1例,对照组患者出现轻度恶心2例,均自行缓解。结论熊去氧胆酸联合多烯磷脂酰胆碱治疗NAFLD疗效显著,可显著改善患者肝功能和血脂水平。

Objective To explore the clinical effect of ursodeoxycholic acid combined with polyene phosphatidylcholine in treatment of non-alcoholic fatty liver disease（ NAFLD）. Methods Ninety-four patients with NAFLD were divided into observation group and control group,forty-seven patients in each group. The patients in control group were treated with ursodeoxycholic acid,and the patients in observation group were treated with ursodeoxycholic acid and polyene phosphatidylcholine. The effect was compared between the two groups after twelve weeks of treatment. Results The total effective rate in observation group and control group was 91. 49%（ 43 /47） and 70. 21%（ 33 /47） respectively,the total effective rate in observation group was significantly higher than that in control group（ P〈0. 05）. There was no significant difference in the levels of alanine transarninase（ ALT）,aspartate aminotransferase（ AST）,total bilirubin（ TBIL） and γ-glutamyl transpeptidase（ γ-GT） between the two groups before treatment（ P〈0. 05）. The levels of ALT,AST,TBIL and γ-GT after treatment were significantly lower than those before treatment in the two groups（ P〈0. 05）. The levels of ALT,AST,TBIL and γ-GT in observation group were significantly lower than those in control group after treatment（ P〈0. 05）. There was no significant difference in the levels of total cholesterol（ TC）,triacylglycerol（ TG）,low density lipoprotein-cholesterol（ LDL-C） and high density lipoprotein-cholesferol（ HDL-C） between the two groups before treatment（ P〈0. 05）. The levels of TC,TG and LDL-C after treatment were significantly lower than those before treatment in the two groups（ P〈0. 05）. The HDL-C level after treatment was significantly higher than that before treatment in the two groups（ P〈0. 05）. The levels of TC,TG and LDL-C in observation group were significantly lower than those in control group after treatment（ P〈0. 05）. The HDL-C level in observation group was significantly higher than that in control group after treatment（ P〈0. 05）. During the treatment,there was one case of diarrhea in observation group,and there was two cases of mild nauseated in control group,both self remission,the three cases were self remission. Conclusions The effect of ursodeoxycholic acid combined with polyene phosphatidylcholine in treatment of NAFLD was significant. It can significantly improve the liver function and blood lipid levels.