阿托伐他汀联合达格列净治疗代谢相关脂肪性肝病的临床效果观察

Clinical effect observation of atorvastatin combined with dapagliflozin in the treatment of metabolic associated fatty liver disease

目的分析阿托伐他汀联合达格列净治疗代谢相关脂肪性肝病的临床效果。方法选取2021年6月至2023年6月内蒙古医科大学附属医院收治的代谢相关脂肪性肝病患者86例,采取双盲、随机数字表法分为对照组和观察组,各43例。对照组采用阿托伐他汀治疗;观察组采用阿托伐他汀联合达格列净治疗,2组均治疗6个月。比较2组治疗前后肝功能指标、肝脏物理指标、血脂指标和糖脂代谢指标。结果治疗6个月后,观察组肝功能指标丙氨酸转氨酶、天冬氨酸转氨酶、碱性磷酸酶水平均低于对照组[(44±6)U/L比(68±7)U/L、(37±4)U/L比(45±4)U/L、(41±7)U/L比(50±9)U/L](均P<0.001)。治疗6个月后,观察组肝脏物理指标脂肪肝指数、肝脏硬度值低于对照组,肝/脾CT值高于对照组(均P<0.05)。治疗6个月后,观察组高密度脂蛋白胆固醇水平高于对照组,低密度脂蛋白胆固醇、三酰甘油、总胆固醇水平低于对照组(均P<0.001)。治疗6个月后,观察组糖脂代谢指标稳态模型胰岛素抵抗指数、三酰甘油葡萄糖乘积指数均低于对照组[(2.1±0.3)比(2.7±0.5)、(4.1±0.7)比(4.6±0.6)](均P<0.001)。结论阿托伐他汀联合达格列净治疗代谢相关脂肪性肝病,能够改善患者肝功能、血脂指标和糖脂代谢指标。

Objective To analyze the clinical effect of atorvastatin combined with dapagliflozin in the treatment of metabolic associated fatty liver disease.Methods Totally 86 patients with metabolic associated fatty liver disease admitted to the Affiliated Hospital of Inner Mongolia Medical University from June 2021 to June 2023 were selected.They were divided into control group and observation group using a double blind random number table method,with 43 cases in each group.The control group was treated with atorvastatin;the observation group was treated with atorvastatin combined with dapagliflozin,and both groups were treated for 6 months.The liver function indicators,liver physical indicators,blood lipid indicators,and glucose lipid metabolism indicators before and after treatment of two groups were compared.Results After 6 months of treatment,the levels of alanine aminotransferase,aspartate aminotransferase,and alkaline phosphatase in the observation group were lower than those in the control group[(44±6)U/L vs(68±7)U/L,(37±4)U/L vs(45±4)U/L,(41±7)U/L vs(50±9)U/L](all P<0.001).After 6 months of treatment,liver physical indicators including fatty liver index and liver hardness value in the observation group were lower than those in the control group,while the CT value of the liver/spleen was higher than that in the control group(all P<0.05).After 6 months of treatment,the high-density lipoprotein cholesterol in the observation group was higher than that in the control group,while the levels of low-density lipoprotein cholesterol,triglycerides,and total cholesterol were lower than those in the control group(all P<0.001).After 6 months of treatment,the glucose and lipid metabolism indicators homeostasis model assessment of insulin resistance and triacylglycerol glucose product index in the observation group were lower than those in the control group[(2.1±0.3)vs(2.7±0.5),(4.1±0.7)vs(4.6±0.6)](both P<0.001).Conclusion The combination of atorvastatin and dapagliflozin in the treatment of metabolic associated fatty liver disease can improve patients′liver function,blood lipid indicators,and glucose lipid metabolism indicators.