多烯磷脂酰胆碱联合二甲双胍治疗对非酒精性脂肪性肝病患者肝纤维化、血浆抵抗素与胰岛素抵抗的影响

Effects of polyene phosphatidylcholine combined with metformin on liver fibrosis,plasma resistin and insulin resistance in patients with nonalcoholic fatty liver disease

[目的]研究多烯磷脂酰胆碱联合二甲双胍治疗对非酒精性脂肪性肝病(NAFLD)患者肝纤维化,血浆抵抗素以及胰岛素抵抗的影响。[方法]选取我院在2015年1月~2017年1月收治的122例NAFLD患者,将患者按照不同治疗方式分成2组(每组61例),对照组患者采用多烯磷脂酰胆碱,观察组患者采用多烯磷脂酰胆碱联合二甲双胍治疗。观察不同治疗方式对患者肝纤维化指标、血浆抵抗素以及胰岛素抵抗的影响。[结果]治疗后观察组患者各项肝纤维化指标为[(90.36±27.54)mg/L、(85.48±26.57)μg/L、(45.21±24.14)μg/L、(85.49±26.84)μg/L],显著低于对照组肝纤维化各项指标值[(144.36±48.75)mg/L、(114.31±35.24)μg/L、(76.24±37.57)μg/L、(123.51±36.58)μg/L、(P<0.05)];2组患者治疗前后Wt、BMI、WC、TG、TC、HDL-C、LDL-C变化情况比较差异无统计学意义(P>0.05);FPG、FINS、ALT、AST、Resistin、HOMA-IR各指标在治疗前比较差异无统计学意义(P>0.05),治疗后观察组患者各指标值为[(4.11±1.14)mmol/L、(8.27(3.21~11.84))mIU/L、(31.51±6.47)U/L、(29.31±7.54)U/L、(12.54±3.14)μg/L、(2.64(1.79~5.12))],显著低于对照组各指标值[(6.23±2.34)mmol/L、(9.95(3.30~11.81))mIU/L、(52.61±8.76)U/L、(37.54±8.21)U/L、(16.62±4.48)μg/L、(3.24(1.71~4.87)),(P<0.05)],2组患者治疗期间未出现不良反应情况。[结论]多烯磷脂酰胆碱联合二甲双胍治疗具有缓解NAFLD患者肝纤维化作用,改善NAFLD患者胰岛素抵抗程度以及降低NAFLD患者血浆抵抗素的表达水平。

[Objective]To investigate the effect of polyene phosphatidylcholine combined with metformin on liver fibrosis,plasma resistin and insulin resistance in patients with nonalcoholic fatty liver disease（NAFLD）.[Methods]A total of 122 cases with NAFLD in our hospital from January 2015 to January 2017 were selected and according to the different treatment methods divided into two groups（61 cases in each group）.The control group was treated with polyene phosphatidylcholine and the observation group treated with polyene phosphatidylcholine combined with metformin.The effects of different treatment methods on the indexes of liver fibrosis,plasma resistin and insulin resistance were observed and compared.[Results]After treatment,the hepatic fibrosis index in the observation group were[（90.36±27.54）mg/L,（85.48±26.57）g/L,（45.21±24.14）g/L,（85.49±26.84）g/L],which were significantly lower than that in the control group[（144.36±48.75）mg/L,（114.31±35.24）g/L,（76.24±37.57）g/L,（123.51±36.58）g/L]（P〈0.05）.The levels of Wt,BMI,WC,TG,TC,HDL-C and LDL-C in two groups of patients before and after treatment were no significant changes（P〈0.05）.There was no significant difference between two groups about the indexes of FPG,FINS,ALT,AST,resistin,HOMA-IR before treatment（P〈0.05）.After treatment,the each index value of the observation group were[（4.11±1.14）mmol/L,（8.27（3.21~11.84））mIU/L,（31.51±6.47）U/L,（29.31±7.54）U/L,（12.54±3.14）g/L,（2.64（1.79~5.12））],which was significantly lower than that in the control group[（6.23±2.34）mmol/L,（9.95（3.30~11.81））mIU/L,（52.61±8.76）U/L,（37.54±8.21）U/L,（16.62±4.48）g/L,（3.24（1.71~4.87））]（P〈0.05）.There was no adverse reactions during treatment in two groups.[Conclusion]Polyene phosphatidylcholine combined with metformin in the treatment of patients with NAFLD can alleviate hepatic fibrosis,improve insulin resistance and reduce the level of plasma resistin.