补充合生素对非酒精性脂肪性肝炎患者肝脂肪变及肝纤维化的影响

Effect of Synbiotics supplementation on steatosis and liver fibrosis in nonalcoholic steatohepatitis

目的探讨补充合生素对非酒精性脂肪性肝炎患者肝脂肪变及肝纤维化程度的影响。方法选取2017年1月至2019年12月佛山市南海区人民医院确诊的80例非酒精性脂肪性肝炎患者,随机分为对照组和研究组,每组40例。所有患者均按医嘱进行适当的有氧运动和饮食控制。对照组给予常规保肝抗炎治疗,研究组在对照组治疗基础上加用合生素治疗。比较分析两组治疗前后的生化指标[三酰甘油(TG)、丙氨酸氨基转移酶(ALT)、γ-谷氨酰转肽酶(GGT)]、白细胞介素-8(IL-8)和胰岛素抵抗指数(HOMA-IR);比较治疗前后的肝脏硬度值及脂肪衰减参数,评估两种方法治疗非酒精性脂肪性肝炎的效果。结果治疗前,研究组与对照组ALT、GGT、TG、IL-8、HOMA-IR水平比较,差异均未见统计学意义(P> 0.05)。治疗后,对照组与研究组患者ALT、GGT、TG、IL-8、HOMA-IR均较本组治疗前明显下降,差异有统计学意义(P <0.05);但两组治疗后ALT、GGT比较,差异未见统计学意义(P> 0.05);两组治疗后TG、IL-8、HOMA-IR水平比较,差异有统计学意义(P <0.05)。治疗后,对照组肝脏硬度值和脂肪衰减参数较治疗前稍有改善,但差异未见统计学意义(P> 0.05);治疗后,研究组肝脏硬度值和脂肪衰减参数较治疗前有明显改善,差异有统计学意义(P <0.01),与对照组治疗后比较差异有统计学意义(P <0.05)。结论补充合生素能降低非酒精性脂肪性肝炎患者的三酰甘油、白细胞介素-8水平,减轻胰岛素抵抗,减轻非酒精性脂肪性肝炎患者肝脏的脂肪变及纤维化程度。

Objective To investigate the effect of supplementation of Synbiotics on the degree of steatosis and liver fibrosis in nonalcoholic steatohepatitis. Methods From January 2017 to December2019,80 patients with nonalcoholic fatty liver hepatitis were selected from Nanhai District People’s Hospital of Foshan. They were randomly divided into control group and study group,with 40 cases in each group. All patients were given proper aerobic exercise and diet control according to the doctor’s advice. The control group was given routine liver protection and anti-inflammatory treatment,and the study group was treated with synbiotic on the basis of the control group. The biochemical indexes[triglyceride( TG),alanine aminotransferase( ALT),gamma glutamyl transpeptidase( GGT) ],interleukin-8( IL-8) and insulin resistance index( HOMA-IR) before and after treatment in the two groups were compared and analyzed. The liver hardness and fat attenuation parameters before and after treatment were compared to evaluate the effect of the two methods on nonalcoholic steatohepatitis.Results Before treatment,there was no significant difference in ALT,GGT,TG,IL-8,HOMA-IR levels between the study group and the control group( P > 0. 05). After treatment,the levels of ALT,GGT,TG,IL-8 or HOMA-IR in the control group and the study group were significantly lower than those before treatment( P < 0. 05). However,there was no significant difference in ALT or GGT between the two groups after treatment( P > 0. 05). After treatment,the TG,IL-8,HOMA-IR levels of the two groups were compared,the differences were significant( P < 0. 05). After treatment,the liver hardness and fat attenuation parameters of the control group were slightly improved,but the difference was not significant( P > 0. 05). After treatment,the liver hardness and fat attenuation parameters in the treatment group were significantly improved compared with those before treatment( P < 0. 01),and there were significant differences between the two groups after treatment( P < 0. 05). Conclusions Synbiotic supplementation can reduce the levels of triglyceride and interleukin-8 in patients with nonalcoholic steatohepatitis,reduce insulin resistance,and reduce the degree of hepatic steatosis and fibrosis in patients with nonalcoholic steatohepatitis.