阿托伐他汀治疗NAFLD患者对肝脂肪变和外周血Treg/Th17细胞的影响

The potential role ofatorvastatin in treating patients with nonalcoholic fatty liver disease

目的探讨阿托伐他汀治疗非酒精性脂肪性肝病(NAFLD)患者对肝脂肪变和外周血调节性T细胞(Treg)/辅助性T细胞17(Th17)的影响。方法2016年6月~2019年6月我院诊治的NAFLD患者148例,采用随机数字表法将患者分为对照组74例和观察组74例,分别给予常规治疗和在此基础上加用阿托伐他汀治疗24 w。采用ELISA法检测白细胞介素-10(IL-10)、IL-17和IL-18水平,使用流式细胞仪检测外周血Treg和Th17细胞百分比。结果在治疗24 w末,观察组血清TC、TG、ALT和AST水平分别为(2.0±0.6)mmol/L、(1.2±0.4)mmol/L、(43.8±8.2)U/L和(25.2±7.4)U/L,显著低于对照组【分别为(2.6±0.6)mmol/L、(1.5±0.3)mmol/L、(49.9±8.4)U/L和(29.2±8.1)U/L,P<0.05】;观察组血清IL-10水平为(31.7±4.4)ng/L,显著高于对照组【(26.3±4.2)ng/L,P<0.05】,而血清IL-17和IL-18水平分别为(89.5±31.0)pg/mL和(41.8±9.1)pg/mL,显著低于对照组【分别为(104.2±29.5)pg/mL和(52.3±9.2)pg/mL,P<0.05】;观察组外周血Treg细胞百分比和Treg/Th17细胞比值分别为(1.2±0.2)%和(1.1±0.4),显著低于对照组【分别为(1.3±0.2)%和(1.3±0.5),P<0.05】,而外周血Th17细胞百分比为(1.1±0.2)%,显著高于对照组【(1.0±0.2)%,P<0.05】;观察组肝脂肪变改善总有效率为94.6%,显著高于对照组的73.0%(P<0.05)。结论应用阿托伐他汀治疗NAFLD患者能显著减轻肝脂肪变,可能与降低了血脂水平,调节了Treg/Th17细胞比例失衡有关。

Objective The aim of this study was to investigate the potential role ofatorvastatin in treating patients with nonalcoholic fatty liver disease(NAFLD).Methods 148 patients with NAFLD were admitted to our hospital between June 2016 and June 2019,and were randomly divided into control(n=74)and observation group(n=74),receiving conventional therapy and atorvastatin treatment at base of conventional therapy,respectively,for 24 weeks.Serum interleukin-10(IL-10),IL-17 and IL-18 were detected by ELISA,and flow cytometry was used to detect the percentages of peripheral blood Treg and Th17 cells.Results At the end of 24 week treatment,blood levels of TC,TG,ALT and AST in the observation group were(2.0±0.6)mmol/L,(1.2±0.4)mol/L,(43.8±8.2)U/L and(25.2±7.4)U/L,significantly lower than[(2.6±0.6)mmol/L,(1.5±0.3)mmol/L,(49.9±8.4)U/L and(29.2±8.1)U/L,respectively,P<0.05]in the control;serum level of IL-10 was(31.7±4.4)ng/L,significantly higher than[(26.3±4.2)ng/L,P<0.05],while serum levels of IL-17 and IL-18 were(89.5±31.0)pg/ml and(41.8±9.1)pg/ml,both significantly lower than[(104.2±29.5)pg/ml and(52.3±9.2)pg/ml,respectively,P<0.05]in the control;the percentages of peripheral blood Treg cells and the ratio of Treg/Th17 cells were(1.2±0.2)%and(1.1±0.4),significantly lower than[(1.3±0.2)%and(1.3±0.5),respectively,P<0.05],while that of Th17 cells was(1.1±0.2)%,significantly higher than[(1.0±0.2)%,P<0.05]in the control;the total improved rate ofhepatic steatosis was 94.6%,significantly higher than 73.0%in the control group(P<0.05).Conclusion The administration of atorvastatin might have a potential role inameliorating liver steatosis in patients with NAFLD,tentatively related to the alleviation of systemic inflammatory reactions and the regulation of Treg/Th17 cellimbalance.