多烯磷脂酰胆碱对酒精性脂肪肝肝纤维化及肝功能的影响

Effect of polyene phosphatidylcholine on liver fibrosis and liver function of alcoholic fatty liver

目的探讨多烯磷脂酰胆碱对酒精性脂肪肝患者肝纤维化及肝功能的影响。方法选取上海市浦东新区公利医院2016年10月至2019年10月收治的酒精性脂肪肝患者58例,按照随机数表法分为观察组和对照组,每组29例,对照组患者给予当飞利肝宁治疗,观察组在当飞利肝宁治疗的基础上给予多烯磷脂酰胆碱治疗,均治疗2个月,治疗结束后,比较两组患者的治疗效果,以及治疗前后的肝纤维化程度和肝功能指标。结果观察组患者的治疗总有效率为89.66%,明显高于对照组的51.72%,差异具有统计学意义(P<0.05);治疗前,两组患者的天冬氨酸转氨酶(AST)、丙氨酸转氨酶(ALT)、总胆固醇(TC)、油三酯(TG)、透明质酸(HA)、层黏连蛋白(LN)、Ⅲ型前胶原(PCⅢ)、Ⅳ型胶原(CIV)比较,差异均无统计学意义(P>0.05);治疗后,观察组和对照组患者的AST[(42.18±12.32) IU/L vs (63.10±15.05) IU/L]、ALT [(45.46±12.35) IU/L vs (66.20±13.47) IU/L]、TC [(6.70±1.40) mmol/L vs(6.56±1.38) mmol/L]、TG [(1.51±0.88) mmol/L vs (2.60±1.11) mmol/L]、HA [(96.71±14.24)μg/L vs (142.12±19.88)μg/L]、LN [(131.11±21.55)μg/L vs (198.93±25.45)μg/L]、PCⅢ[(94.20±11.21)μg/L vs (153.27±15.45)μg/L]及CIV [(78.93±6.56)μg/L vs(126.71±11.41)μg/L]比较,观察组明显低于对照组,差异均具有统计学意义(P<0.05)。结论多烯磷脂酰胆碱可以显著提高酒精性脂肪肝的治疗效果,改善患者的肝功能状态,延缓肝纤维化的进程,值得临床推广。

Objective To investigate the effect of polyene phosphatidylcholine on liver fibrosis and liver function in patients with alcoholic fatty liver. Methods Fifty-eight patients with alcoholic fatty liver admitted to Shanghai Pudong New Area Gongli Hospital from October 2016 to October 2019 were divided into the observation group and control group according to random number table method, with 29 patients in each group. The control group was treated with Dangfei Liganning, and the observation group was given polyene phosphatidylcholine treatment on the basis of Dangfei Liganning treatment, both for 2 months. After the treatment was completed, the treatment effects and the index of liver fibrosis and liver function of the two groups were compared. Results The total effective rate of treatment in the observation group was 89.66%, which was significantly higher than 51.72% in the control group(P<0.05). Before treatment,there was no significant difference between the two groups in aspartate aminotransferase(AST), alanine aminotransferase(ALT), total cholesterol(TC), triolein(TG), hyaluronic acid(HA), laminin(LN), type Ⅲ procollagen(PCⅢ), typeⅣ collagen(CIV)(all P>0.05);after treatment, AST, ALT, TC, TG, HA, LN, PCⅢ, CIV in the observation group were(42.18 ± 12.32) IU/L,(45.46 ± 12.35) IU/L,(6.70 ± 1.40) mmol/L,(1.51 ± 0.88) mmol/L,(96.71 ± 14.24) μg/L,(131.11 ±21.55) μg/L,(94.20±11.21) μg/L,(78.93±6.56) μg/L, respectively, which were significantly lower than corresponding(63.10±15.05) IU/L,(66.20±13.47) IU/L,(6.56±1.38) mmol/L,(2.60±1.11) mmol/L,(142.12±19.88) μg/L,(198.93±25.45) μg/L,(153.27±15.45) μg/L,(126.71±11.41) μg/L in the control group(all P<0.05). Conclusion Polyene phosphatidylcholine can significantly increase the therapeutic effect of alcoholic fatty liver, improve the liver function status of patients, and delay the progress of liver fibrosis, which is worthy of clinical promotion.