阿托伐他汀联合多烯磷脂酰胆碱治疗代谢相关脂肪性肝病的临床效果

Clinical efficacy of atorvastatin combined with polyene phosphatidyl choline in the treatment of metabolic associated fatty liver disease

目的 探讨阿托伐他汀联合多烯磷脂酰胆碱胶囊治疗代谢相关脂肪性肝病(MAFLD)的临床效果评价。方法 回顾性纳入2018~2019年浙江大学附属第二医院临平院区收治的符合MAFLD诊断的新患者98例,根据不同服药治疗情况分为观察组(43例)和对照组(55例),其中观察组服用阿托伐他汀联合多烯磷脂酰胆碱胶囊治疗,对照组单用多烯磷脂酰胆碱胶囊治疗,服药6个月后,两组患者进行治疗效果评价,比较两组患者肝功能指标、血生化因子及炎症因子的水平,并统计不良反应发生的情况。结果 治疗后,观察组和对照组的总有效率分别为90.70%和76.36%,差异有统计学意义(P<0.05)。在肝功能指标中,观察组的谷丙转氨酶(ALT)、谷草转氨酶(AST)及碱性磷酸酶(ALP)水平明显低于对照组指标(均P<0.05)。在血清生化和炎症因子水平方面,观察组的核转录因子-κB(NF-κB)、转化生长因子-β(TGF-β)、C-反应蛋白(CRP)及肿瘤坏死因子-α(TNF-α)水平明显低于对照组(均P<0.05)。两组的不良反应率比较,差异无统计学意义(P>0.05)。结论 阿托伐他汀联合多烯磷脂酰胆碱治疗代谢相关脂肪性肝病肝功能得到改善,安全性高,副作用小,值得临床推广应用。

Objective To investigate and assess the clinical efficacy of atorvastatin combined with polyene phosphatidyl choline(PPC) capsules in the treatment of metabolic associated fatty liver disease(MAFLD). Methods A total of 98 patients with MAFLD admitted to Linping Campus, the Second Affiliated Hospital of Zhejiang University School of Medicine from January 2018 to June 2019 were included and randomly divided into the observation group(n=43) and the control group(n=55) according to the time order of admission, using the odd and even number method. The observation group was treated with atorvastatin combined with PPC capsules, while the control group was treated with PPC capsules. At the end of the treatment, the clinical efficacy of the both groups was evaluated, the expression levels of liver function indicators, serum biochemical factors and inflammatory factors were compared between the two groups, and the occurrence of adverse reactions were counted. Results After treatment, the total effective rates of the observation group and the control group were 90.70% and 76.36%, respectively, with statistically significant differences(P<0.05). In terms of the liver function indicators, the levels of glutamate transaminase(ALT), glutathione transaminase(AST) and alkaline phosphatase(ALP) in the observation group were significantly lower than those in the control group(all P<0.05). In terms of the serum biochemical and inflammatory factor levels, the levels of nuclear factor-κB(NF-κB), transforming growth factor-β(TGF-β), hypersensitive C-reactive protein(hs-CRP) and tumor necrosis factor-α(TNF-α) in the observation group were significantly lower than those in the control group(P<0.05). There was no statistically significant difference between the two groups in the incidence of adverse reactions(all P>0.05). Conclusion Atorvastatin combined with PPC capsules is clinically effective in the treatment of MAFLD, with improved liver function and high safety.