氟伐他汀治疗非酒精性脂肪性肝病临床疗效及对患者血清炎性因子、肝脏组织脂肪变性及纤维化程度的影响

Clinical efficacy of fluvastatin in the treatment of nonalcoholic fatty liver disease and its effects on inflammatory factors,liver steatosis and fibrosis

[目的]研究氟伐他汀治疗非酒精性脂肪性肝病临床疗效以及对患者血清炎性因子、肝脏组织脂肪变性以及纤维化程度的影响。[方法]采用回顾性方式对我院在2015年1月~2017年收治的88例非酒精性脂肪肝患者临床资料进行分析。根据不同治疗方式将患者分成观察组与对照组(每组44例),对照组患者采用口服降糖、降血脂药物治疗,观察组患者在对照组基础上加用氟伐他汀治疗。观察不同治疗方式对2组患者血清炎性因子、肝脏组织脂变性以及纤维化程度的影响。[结果]治疗后观察组患者有效为88.64%,显著高于对照组[(68.18%),P<0.05];治疗前2组患者hs-CRP、TNF-α、IL-6、ALT、AST表达水平情况比较无差异(P>0.05);治疗后观察组hs-CRP为(7.54±1.36)mg/L,显著低于对照组[(14.62±2.57)mg/L,P<0.05],TNF-α为(12.62±2.51)ng/L,显著低于对照组[(28.62±5.47)ng/L,P<0.05],IL-6为(12.54±2.34)ng/L,显著低于对照组[(38.61±6.85)ng/L,P<0.05],ALT为(46.59±8.57)U/L,显著低于对照组[(58.34±10.52)U/L,P<0.05],AST为(35.67±8.67)U/L,显著低于对照组[(44.63±12.52)U/L,P<0.05];HDL-C、BMI两指标治疗前后比较均无差异(P>0.05),而TG、TC、LDL-C、FBG各指标在治疗前比较无差异(P>0.05),治疗后观察组患者TG为(1.04±0.26)mmol/L,显著低于对照组[(2.85±0.66)mmol/L,P<0.05)];TC为(3.02±0.46)mmol/L,显著低于对照组[(5.10±1.12)mmol/L,P<0.05];LDL-C为(1.32±0.35)mmol/L,显著低于对照组[(3.02±1.03)mmol/L,P<0.05];FBG为(4.87±1.46)mmol/L,显著低于对照组[(6.87±1.85)mmol/L,P<0.05];治疗前2组患者HA、PCⅢ、CⅣ、LN比较差异无统计学意义(P>0.05),治疗后观察组患者HA为(98.57±21.31)μg/L,显著低于对照组[(162.57±35.85)μg/L,P<0.05];PCⅢ为(86.57±18.57)μg/L,显著低于对照组[(135.67±27.54)μg/L,P<0.05];CⅣ为(84.65±13.57)μg/L,显著低于对照组[(136.75±22.51)μg/L,P<0.05];LN为(74.26±14.53)μg/L,显著低于对照组[(114.02±20.42)μg/L,P<0.05];2组患者治疗期间均未出现严重不良反应情况。[结论]氟伐他汀治疗非酒精性脂肪性肝病可减低血清炎症因子、血脂指标以及肝纤维化指标表达水平,抑制炎症反应,改善患者血脂代谢异常,减轻肝脏组织脂肪变性及纤维化程度。

[Objective]To investigate the clinical efficacy of fluvastatin in the treatment of nonalcoholic fatty liver disease and its effects on inflammatory factors,liver steatosis and fibrosis, [Methods]The clinical data of 88 patients with nonalcoholic fatty liver disease treated in our hospital from January 2015 to 2017 were retrospectively analyzed. According to the different treatments, the patients were divided into observa- tion group and control group（n=44）. The patients in the control group were treated with oral hypoglyce-mic and lipid-lowering drug treatment and the patients in the observation group were given with fluvastatin on the basis of the control group treatment. The effects of different treatment methods on serum inflamma- tory factors,liver steatosis and fibrosis were observed and compared between the two groups. [Results]Af- ter treatment,the effective rate in the observation group was 88.64% ,which was significantly higher than that in the control group（68. 18%）（P〈0. 05）. Before treatment, the hs-CRP, IL-6,ALT, TNF-a,AST ex- pression levels had no significant difference between the two groups（P〉0.05）. After treatment,the hs- CRP in the observation group was（7.54±1.36）mg/L,which was significantly lower than that in the con- trol group[（14.62±2.57）mg/L,P〈0. 05]. The TNF-a in the observation group was（12.62±2.51）ng/L, which was significantly lower than that in the control group[（28.62±5.47）ng/L,P〈0.05]. The IL-6 in the observation group was（12. 54±2. 34）ng/L, which was significantly lower than that in the control group [（38.61±6.85）ng/L,P〈O. 05]. The ALT in the observation group was（46.59±8.57）U/L,which was significantly lower than that in the control group[ （58. 34±10. 52）U/L, P〈0. 05]. The AST in the obser- vation group was（35.67±8.67）U/L,which was significantly lower than that in the control group[（44.63 ±12.52）U/L,P〈O. 05]. The HDL-C and BMI showed no significant difference between two groups（P〉 0. 05）. The levels of TG,TC,LDL-C and FBG showed no significant difference between two groups before treatment（P〈0.05）. After treatment, the TG in the observation group was （ 1.04±0.26） mmol/L, which was significantly lower than that in the control group E （2.85 ±0. 66）mmol/L, P〈 0.05）]. The TC in the observation group was（3.02±0.46）mmol/L,which was significantly lower than that in the control group E（5.10±1.12）mmol/L,P〈O. 05]. The LDL-C in the observation group was（1.32!0.35）mmol/L,which was significantly lower than that in the control group（3.02±1.03）mmol/L, P〈O. 05]. The FBG in the observation group was（4. 87＋1.46）mmol/L,which was significantly lower than that in the control group [（6.87±1.85）mmol/L,P〈O. 05]. Before treatment,the HA,PC III,CIV ,LN showed no significant differ- ence between two groups （P〈0.05）. After treatment, the HA in the observation group was （98.57 H 21.31） g/L, which was significantly lower than the control group [ （ 162.57±35.85） g/L, P 〈 0. 05 ]. The PCIII in the observation group was（86.57±18.57）g/L,which was significantly lower than that in the con- trol groupE（135.67±27.54）g/L,P〈0.05]. The CIV which was significantly lower than that in the control in the observation group was（84.65±13.57）g/L, group[（136.75±22.51）g/L,P〈0. 05]. The LN in the observation group was（74.26±14.53）g/L,which was significantly lower than that in the control group [（114.02±20. 42）g/L,P〈O. 05]. There was no serious adverse reactions in two groups during treatment. [Conelusion]uvastatin in the treatment of nonalcoholic fatty liver disease can reduce the serum inflamma- tory factors, blood lipid index and liver fibrosis index levels and inhibit inflammation, improve abnormal lip- id metabolism and relieve liver fatty degeneration and fibrosis degree.