阿托伐他汀联合硫普罗宁治疗对非酒精性脂肪肝病患者血清ALT、AST、GGT和IR指标的影响  

Effects of Atorvastatin Combined with Tiopronin on Serum ALT,AST,GGT and IR Indicators in Patients with Non-alcoholic Fatty Liver Disease

作　　者：黄晓丽[1] 冯凯祥[1] HUANG Xiao-li;FENG Kai-xiang(Department of Gastroenterology,Mianyang Central Hospital,Mianyang 621000,China)

机构地区：[1]绵阳市中心医院消化内科,四川绵阳621000

出　　处：《标记免疫分析与临床》2019年第3期481-485,共5页Labeled Immunoassays and Clinical Medicine

摘　　要：目的探讨阿托伐他汀联合硫普罗宁治疗对非酒精性脂肪肝病(NAFLD)患者血清肝功能和胰岛素抵抗(IR)指标的影响。方法抽取2016年6月至2017年12月期间来本医院就诊的75例NAFLD患者为研究对象,采用随机双盲法分为对照组(n=37)、实验组(n=38),前者给予硫普罗宁肠溶片治疗,后者加服阿托伐他汀钙片,均连续治疗8周。治疗前后检测血清肝功能指标[丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、谷氨酰转移酶(GGT)],血脂指标[三酰甘油(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)]及IR指标[胰岛素样生长因子-1(IGF-1)、脂联素、稳态胰岛素抵抗指数(HOMA-IR)],并评定治疗疗效。结果两组治疗前血清肝功能指标、血脂指标及IR指标比较差异无统计学意义(P>0. 05),治疗后实验组患者血清ALT、AST、GGT、TG、TC、LDL-C水平及HOMA-IR显著低于对照组,HDL-C、IGF-1、脂联素水平明显高于对照组,差异均有统计学意义(P<0.05)。实验组患者临床总有效率略高于对照组(89.47%vs78.37%),但差异无统计学意义(P>0.05)。结论阿托伐他汀联合硫普罗宁治疗可有效改善NAFLD患者肝功能、血脂代谢及IR,从而有望提高临床治疗疗效。Objective To investigate the effects of atorvastatin combined with tiopronin on serum liver function indexes and insulin resistance(IR)indicators in patients with non-alcoholic fatty liver disease(NAFLD).Methods A total of 75 patients with NAFLD treated in the hospital during the period from June 2016 to December 2017 were selected as the study subjects.They were randomly divided into the control group(n=37)and the experimental group(n=38).The former group was treated with tiopronin enteric-coated tablets,and the latter group was additionally treated with atorvastatin calcium tablets.Both groups underwent 8 weeks of treatment.Serum liver function indicators[alanine aminotransferase(ALT),aspartate aminotransferase(AST),glutamyl transferase(GGT)],blood lipids[triglyceride(TG),total cholesterol(TC),high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C)]and IR indicators[insulin-like growth factor-1(IGF-1),adiponectin,steady-state insulin resistance index(HOMA-IR)]were detected before and after the treatment.The curative effect was then evaluated.Results There were no significant differences in serum liver function indexes,blood lipids or IR indexes between the two groups before the treatment(P>0.05).Levels of serum ALT,AST,GGT,TG,TC and LDL-C and HOMA-IR in the experimental group were significant lower than those in the control group while levels of HDL-C,IGF-1 and adiponectin were significantly higher than those in the control group after the treatment(P<0.05).The total clinical effective rate of the experimental group was slightly higher than that of the control group(89.47%vs 78.37%)(P>0.05).Conclusion Atorvastatin combined with tiopronin can effectively improve the liver function,lipid metabolism and IR in patients with NAFLD,thus improving the clinical curative effect.

关 键 词：阿托伐他汀 硫普罗宁 非酒精性脂肪肝病 胰岛素抵抗 

分 类 号：R575.5[医药卫生—消化系统]