牛磺熊去氧胆酸联合多烯磷酯酰胆碱治疗对非酒精性脂肪性肝病患者肝功能及血清RBP4水平的影响

Effects of taurine ursodeoxycholic acid and polyene phosphatidylcholine on liver function and serum RBP4 level in patients with non-alcoholic fatty liver disease

目的:探讨牛磺熊去氧胆酸(TUDCA)联合多烯磷酯酰胆碱(PPC)治疗非酒精性脂肪性肝病(NAFLD)对患者肝功能、血清视黄醇结合蛋白4(RBP4)水平的影响。方法:选取120例NAFLD患者为研究对象,按治疗方式不同分为PPC组和TUDCA组,每组各60例。PPC组给予多烯磷酯酰胆碱治疗;TUDCA组给予TUDCA联合多烯磷酯酰胆碱治疗,疗程均为6个月。比较两组患者临床疗效、肝功能[冬氨酸氨基转移酶(AST)、谷丙转氨酶(ALT)及谷氨酰转肽酶(GGT)水平]、肝脏超声脂肪变性评分变化、血脂指标[总胆固醇(TC)及三酰甘油(TG)水平]、血清脂质过氧化指标[过氧化脂质(LPO)、氧化低密度脂蛋白(ox-LDL)及总抗氧化能力(T-AOC)水平]、血清RBP4水平及不良反应发生情况。结果:TUDCA组患者治疗总有效率高于PPC组(96.67%vs.86.67%,P<0.05)。治疗后,两组患者AST、ALT、GGT、肝脏超声脂肪变性评分、TC、TG、LPO、ox-LDL、RBP4水平均降低(P<0.05),且TUDCA组低于PPC组(P<0.05);T-AOC水平均升高(P<0.05),且TUDCA组高于PPC组(P<0.05)。两组患者治疗期间不良反应发生率比较,差异无统计学意义(P>0.05)。结论:TUDCA联合PPC治疗能有效改善NAFLD患者肝功能和肝脂肪变性,降低血脂、脂质过氧化指标及RBP4水平。

Objective:To explore the effects of taurine ursodeoxycholic acid(TUDCA)and polyene phosphatidylcholine(PPC)on liver function and serum retinol-binding protein 4(RBP4)level in the treatment of non-alcoholic fatty liver disease(NAFLD).Methods:120 patients with NAFLD were selected and divided into PPC group and TUDCA group according to the different treatment methods,with 60 cases in each group.The PPC group was treated with PPC,and the TUDCA group was treated with TUDCA combined with PPC for 6 months.The efficacy,liver function[levels of aspartate aminotransferase(AST),alanine aminotransferase(ALT),and gamma-glutamyl transpeptidase(GGT)],changes in ultrasonic liver steatosis score,serum lipids indicators[levels of total cholesterol(TC)and triacylglycerol(TG)],serum lipid peroxidation indicators[levels of lipid peroxidation(LPO),oxidized low-density lipoprotein(ox LDL),and total antioxidant capacity(T-AOC)],serum RBP4 level and adverse reactions were compared between the two groups.Results:The total effective rate in TUDCA group was higher than that in PPC group(96.67%vs.86.67%,P<0.05).After treatment,the levels of AST,ALT and GGT,ultrasonic liver steatosis score,TC,TG,LPO,ox-LDL,and serum RBP4 were lower than those of before treatment(P<0.05),and the TUDCA group was lower than the PPC group(P<0.05).The levels of T-AOC was higher than that of before treatment(P<0.05),and the TUDCA group was higher than the PPC group(P<0.05).There was no statistical significance in the incidence rate of adverse reactions between the two groups(P>0.05).Conclusion:TUDCA and PPC can effectively improve the liver function and liver steatosis,reduce the levels of serum lipids,lipid peroxidation indicators,and RBP4 in patients with NAFLD.