非诺贝特联合双环醇治疗非酒精性脂肪性肝病患者肝组织PPARγ2 mRNA水平变化  

Application of fenofibrate and bicyclol combination in treatment of patients with non-alcoholic fatty liver diseases and changes of hepatic PPARγ2

作　　者：李钊 黄赞松[2] 李繁 Li Zhao;Huang Zansong;Li Fan(Department of Infectious Diseases,People's Hospital,Hezhou 542899,Guangxi Zhuang Autonomous Region,China)

机构地区：[1]广西壮族自治区贺州市人民医院感染性疾病科,542899 [2]右江民族医学院附属医院消化内科

出　　处：《实用肝脏病杂志》2021年第1期59-62,共4页Journal of Practical Hepatology

基　　金：贺州市科学研究与技术开发计划项目(贺科转1908022)。

摘　　要：目的探讨应用非诺贝特联合双环醇治疗非酒精性脂肪性肝病(NAFLD)患者的疗效及肝组织过氧化物酶体增殖物激活受体γ2(PPARγ2)水平变化。方法2018年2月~2019年12月我院收治的NAFLD患者66例,采用随机数字表法分为对照组33例和观察组33例,分别给予双环醇片口服或在此基础上给予非诺贝特片口服治疗,两组均治疗3个月。肝穿刺获得肝组织,采用PCR法检测肝组织PPARγ2 mRNA水平,采用化学发光免疫分析法检测血清肿瘤坏死因子-α(TNF-α)和白介素-6(IL-6)水平,采用免疫比浊法检测血清超敏C反应蛋白(hs-CRP)水平,使用FC500型流式细胞仪检测外周血CD3^+、CD4^+和CD8^+细胞百分比。结果在治疗结束时,观察组总有效率为97.0%,显著高于对照组的66.7%(P<0.05);观察组肝组织PPARγ2 mRNA相对水平为(1.5±0.1),显著高于对照组【(1.1±0.2),P<0.05】;观察组血清TNF-α水平为(26.4±3.1)pg/mL,显著低于对照组【(32.8±6.9)pg/mL,P<0.05】,血清IL-6水平为(35.9±4.9)ng/L,显著低于对照组【(46.4±5.8)ng/L,P<0.05】,血清hs-CRP水平为(5.1±1.4)mg/L,显著低于对照组【(8.4±1.9)mg/L,P<0.05】;观察组外周血CD3^+细胞百分比为(80.2±11.5)%,显著高于对照组【(60.5±7.7)%,P<0.05】,外周血CD4^+细胞百分比为(44.7±5.8)%,显著高于对照组【(31.4±4.8)%,P<0.05】,CD4^+/CD8^+细胞比值为(1.5±0.4),显著高于对照组【(1.1±0.3),P<0.05】。结论联合应用非诺贝特和双环醇治疗NAFLD患者有短期疗效,可能与提高了肝组织PPARγ2水平,降低了血清炎症细胞因子水平有关,值得进一步研究。Objective To explore the efficacy of fenofibrate and bicyclol combination in the treatment of patients with non-alcoholic fatty liver diseases(NAFLD)and its influence on hepatic peroxisome proliferator-activated receptor gammaγ2(PPARγ2)mRNA level.Methods 66 patients with NAFLD were admitted to our hospital between February 2018 and December 2019,and were randomly divided into control group(n=33)and observation group(n=33),receiving bicyclol or bicyclol and fenofibrate combination for three months.The curative effect in the two groups after treatment were compared.The liver biopsies were performed,and hepatic PPARγ2 messenger ribonucleotide(mRNA)were assayed by PCR.Serum cytokines and peripheral blood T lymphocyte subsets were compared.Results At the end of the treatment,the total effective rate in the observation group was 97.0%,which was much higher than that in the control group(66.7%,P<0.05);the relative level of PPARγ2 mRNA in liver tissues in the observation group was(1.5±0.1),significantly higher than[(1.1±0.2),P<0.05]in the control;serum tumor necrosis factor-α(TNF-α)level was(26.4±3.1)pg/mL,significantly lower than[(32.8±6.9)pg/mL,P<0.05],serum IL-6 level was(35.94.9)ng/L,significantly lower than(46.45.8)ng/L,P<0.05,and serum high-sensitivity C-reactive protein(hs-CRP)level was(5.1±1.4)mg/L,much lower than[(8.4±1.9)mg/L,P<0.05]in the control;the percentage of peripheral blood CD3^+ cells was(80.2±11.5)%,significantly higher than[(60.5±7.7)%,P<0.05],the percentage of peripheral blood CD4^+ cells was(44.7±5.8)%,significantly higher than[(31.4±4.8)%,P<0.05],and the ratio of CD4^+/CD8^+ cells was(1.5±0.4),significantly higher than[(1.1±0.3),P<0.05]in the control.Conclusion The oral administration of fenofibrate and bicyclol combination in the treatment of patients with NAFLD has a short-term efficacy,which might be related to the increased hepatic PPARγ2 mRNA levels and the reduction of serum cytokine levels.

关 键 词：非酒精性脂肪性肝病 非诺贝特 双环醇 过氧化物酶体增殖物激活受体γ2 细胞因子 治疗 

分 类 号：R575.5[医药卫生—消化系统]