微粒化非诺贝特治疗高脂血症性胰腺炎的疗效及相关实验室指标观察

Effects of micronized fenofibrate in treatment of hyperlipidemic acute pancreatitis and observation of relevant laboratory indicators

目的研究微粒化非诺贝特治疗高脂血症性胰腺炎(HLAP)的疗效及对相关实验室指标的影响。方法纳入2015年8月—2019年8月京市溧水区人民医院50例HLAP患者作为研究对象,采用随机数字表法将50例患者分为观察组(n=25)和对照组(n=25)。对照组给予常规调脂干预,观察组给予微粒化非诺贝特。比较两组患者血脂指标[总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)及低密度脂蛋白胆固醇(LDL-C)]、血粘度[高切/低切全血粘度、血浆粘度及游离脂肪酸(FFA)]、炎性因子[C反应蛋白(CRP)、白介素-6(IL-6)及肿瘤坏死因子-α(TNF-α)]及胰岛功能指标[胰岛素抵抗指数(HOMA-IR)、胰岛β细胞功能(HOMA-β)及胰岛素敏感指数(ISI)]水平。结果治疗后观察组TC、TG及LDL-C均低于对照组,HDL-C高于对照组,差异均有统计学意义(P<0.05)。治疗后观察组血浆粘度、高切和低切全血粘度及FFA均低于对照组,差异均有统计学意义(P<0.05)。治疗后观察组IL-6、TNF-α及CRP均显著低于对照组,差异均有统计学意义(P<0.05)。治疗后观察组ISI和HOMA-β均显著高于对照组,HOMA-IR显著低于对照组,差异均有统计学意义(P<0.05)。结论微粒化非诺贝特治疗HLAP疗效显著,有助于改善患者胰岛功能和血粘度,抑制炎症反应。

Objective To study the effects of micronized fenofibrate in treatment of hyperlipidemic acute pancreatitis(HLAP)and observe the relevant laboratory indicators.Methods 50 patients with HLAP were randomly divided into 2 equal groups:control group undergoing regular lipid regulation intervention,and observation group given,in addition,micronized fenofibrate 200 mg once a night for 8 weeks.Peripheral blood samples were collected before and after the treatment to examine the levels of total cholesterol(TC),triglyceride(TG),high density lipoprotein-cholesterol(HDL-C),and low-density lipoprotein cholesterol(LDL-C)by automatic biochemical analyzer,high shear and low shear whole blood viscosity,and plasma viscosity by blood viscometer,.Znd serum free fatty acid(FFA)by colorimetry,inflammatory factors[C-reactive protein(CRP),interleukin-6(IL-6),and tumor necrosis factor-α(TNF-α)]by ELISA.Homeostasis model assessment-of insulin resistance(HOMA-IR),islet cell function(HOMA-β),and insulin sensitivity index(IS)were calculated.Results The TC,TG and LDL-C levels after treatment of the observation group were all significantly lower than those of the control group(all P<0.05),and the HDL-C level after treatment of the observation group was significantly higher than that of the control group(P<0.05).The levels of plasma viscosity,high and low shear whole blood viscosity,and FFA after treatment of the observation group were all significantly lower than those of the control group(all P<0.05),and the levels ofIL-6,TNF-αand CRP after treatment of the observation group were all significantly lower than those of the control group(all P<0.05).The levels of ISI and HOMA-βafter treatment of the observation group were significantly higher than those of the control group,and the HOMA-IR level after treatment of the observation group was significantly lower than that of the control group(all P<0.05).Conclusion Effective in the treatment of HLAP,micronized fenofibrate helps improve the function of islets of Langerhans and blood viscosity,and suppress inflammatory response.