补充维生素D对非酒精性脂肪性肝炎患者的疗效观察  

Efficacy of Vitamin D Supplementation in Patients with Nonalcoholic Steatohepatitis

作　　者：那美倩 王桂君 Na Meiqian;Wang Guijun(Jinzhou Medical University,Jinzhou 121000 China)

机构地区：[1]锦州医科大学,辽宁锦州121000

出　　处：《锦州医科大学学报》2023年第2期79-84,共6页Journal of Jinzhou Medical University

基　　金：辽宁省科技厅面上项目,项目编号:2021-MS-323。

摘　　要：目的 探讨在饮食管理、运动及复方二氯醋酸二异丙胺片治疗的基础上,补充维生素D对非酒精性脂肪性肝炎患者的疗效观察。方法 2018年3月至2019年9月期间就诊于锦州医科大学附属第一医院门诊及健康检查的NASH伴维生素D缺乏的204名人群纳入本研究。由于部分人群失访和退出,共196例完成本研究。对照组100例,给予饮食、运动及复方二氯醋酸二异丙胺治疗。实验组96例,在对照组基础上给予维生素D滴剂胶囊治疗。均治疗12 w。观察两组患者治疗前后的一般资料、肝功、血脂、血糖、25(OH)D、炎症因子、临床症状、肝/脾CT比值变化情况。结果 两组治疗后,患者BMI、腰围、GGT、AST、ALT、HOMA-IR、FPG、FINS、TG、TC、LDL-C、TNF-α、IL-6均下降(P<0.05),25(OH)D和HDL-C均升高(P<0.05),临床症状及肝/脾CT比值均改善(P<0.05),实验组改善更明显(P<0.05)。实验组总有效率(91.67%)优于对照组总有效率(76.0%)(P<0.05)。结论 补充维生素D后通过升高25(OH)D水平,改善血糖血脂代谢紊乱,降低炎症指标水平,进而改善NASH的各项指标及临床症状。Objective To investigate the effect of vitamin D supplementation on patients with nonalcoholic steatohepatitis on the basis of diet management,exercise and compound diisopropylamine dichloroacetate tablets.Methods A total of 204 NASH patients with vitamin D deficiency admitted to the First Affiliated Hospital of Jinzhou Medical University from March 2018 to September 2019 were included in the study.A total of 196 patients completed the study due to loss of follow-up and withdrawal.Control group of 100 patients was treated with diet,exercise and compound diisopropylamine dichloroacetate.The experimental group of 96 patients was treated with vitamin D drops and capsules on the basis of control group.All patients were treated for 12 weeks.General data,liver function,blood lipid,blood glucose,25(OH)D,inflammatory factors,clinical symptoms,and the changes of liver/spleen CT ratio before and after treatment were observed in two groups.Results After treatment,BMI,waist circumference,GGT,AST,ALT,HOMA-IR,FPG,FINS,TG,TC,LDL-C,TNF-αand IL-6 were decreased(P<0.05),while 25(OH)D and HDL-C were increased(P<0.05).Both clinical symptoms and liver/spleen CT ratio were improved(P<0.05),and the improvement was more obvious in the experimental group(P<0.05).The total effective rate of the experimental group(91.67%)was better than that of the control group(76.0%)(P<0.05).Conclusion By increasing the level of 25(OH)D,the supplementation of vitamin D can improve the disorder of blood glucose and lipid metabolism,reduce the level of inflammatory indicators,and then improve the indexes and clinical symptoms of NASH.

关 键 词：维生素D 非酒精性脂肪性肝炎 复方二氯醋酸二异丙胺 胰岛素抵抗 

分 类 号：R575.5[医药卫生—消化系统]