吡格列酮对非酒精性脂肪性肝病患者的氧化应激参数和炎症因子的影响  

Effects of pioglitazone on oxidative stress-related parameters and inflammatory cytokines in patients with nonalcoholic fatty liver disease

作　　者：方文军[1] 陆帅[2] 王娟[2] 胡静芳[1] 苏青[1] 

机构地区：[1]上海交通大学医学院附属新华医院内分泌科,上海200092 [2]上海交通大学医学院附属新华医院崇明分院内分泌科,上海202150

出　　处：《内科理论与实践》2013年第4期241-245,共5页Journal of Internal Medicine Concepts & Practice

基　　金：上海市卫生局课题(项目编号:2009238)

摘　　要：目的:观察吡格列酮对非糖尿病非酒精性脂肪性肝病(NAFLD)患者肝脏脂肪含量及氧化应激参数和炎症因子水平的影响,探讨吡格列酮防治NAFLD的可能作用机制。方法:采用随机、单盲、对照组的研究。106例非糖尿病NAFLD患者随机分为吡格列酮组52例和对照组54例,对照组予以常规生活方式干预,吡格列酮组在常规生活方式干预的基础上予吡格列酮30 mg,1次/d,疗程均为24周。检测2组患者干预前后的肝/脾CT比值、血清丙氨酸转氨酶(ALT)、γ-谷氨酰转肽酶(GGT)、游离脂肪酸(FFA)、丙二醛(MDA)、4-羟壬烯醛(4-HNE)、白介素(IL)-1β、IL-6和肿瘤坏死因子(TNF)-α,用稳态模型评估胰岛素抵抗指数(HOMA-IR)。结果:治疗前2组各项指标均无显著差异(P>0.05)。对照组干预前后上述指标均无明显变化(均P>0.05)。吡格列酮组治疗后肝/脾CT比值明显升高(P<0.05),血清ALT、GGT、FFA、MDA、4-HNE、IL-1β、IL-6、TNF-α、HOMA-IR均明显下降(均P<0.05)。结论:吡格列酮治疗可以明显减轻NAFLD患者肝脏脂肪含量,降低NAFLD患者的氧化应激参数和炎症因子水平。Objective To investigate the effect of pioglitazone on oxidative stress-related parameters and inflammatory cytokines in patients with nonalcoholic fatty liver disease （NAFLD）. Methods In this randomized,single- blind,controlled study, 106 patients with NAFLD without diabetes were randomized into two groups. Fifty-two patients in the pioglitazone group received pioglitazone 30 mg/d with a course of 24 weeks, while the other 54 patients were served as controls. The levels of serum alanine aminotransferase （ALT）, gamma-glutamyl transferase （GGT）, free fatty acids （FFA）, malondialdehyde （MDA）, 4-hydroxy-2-nonenal （4-HNE）, interleukin （IL）-lβ, IL-6, tumor necrosis factor-or （TNF-α）, CT value ratio of liver and spleen, and homeostatic model assessment for insulin resistance （HOMA-IR） were measured before and after treatment. Results There were no significantly differences in baseline characteristics between two groups （P〉 0.05）. After 24 weeks treatment,CT value ratio of liver and spleen increased （P〈0.05）, and the levels of serum ALT, GGT, FFA, MDA, 4-HNE, IL-1β, IL-6, TNF-α and HOMA-IR decreased in pioglitazone group （all P〈0.05）, and no obvious changes was observed in control group. No serious adverse reaction was observed in pioglitazone group. Conclusions Pioglitazone may decrease hepatic fat content and levels of oxidative stress-related parameters and inflammatory cytokines in patients with NAFLD.

关 键 词：吡格列酮 非酒精性脂肪性肝病 氧化应激 炎症因子 肝 脾CT比值 

分 类 号：R575.5[医药卫生—消化系统]