生活方式干预治疗代谢相关脂肪性肝病的疗效观察  

Observation on the Efficacy of Lifestyle Interventions in the Treatment of Metabolism-related Fatty Liver Disease

作　　者：王誉敏 游云龙 孙静 郑勇[2] 陈卫刚[2] WANG Yu-min;YOU Yun-long;SUN Jing;ZHENG Yong;CHEN Wei-gang(Shihezi University School of Medicine,Xinjiang Shihezi,832002;Department of Gastroenterology,the First Affiliated Hospital of Shihezi University,Xinjiang Shihezi,832008)

机构地区：[1]石河子大学医学院,新疆石河子832002 [2]石河子大学第一附属医院消化内科,新疆石河子832008

出　　处：《农垦医学》2023年第2期112-118,共7页Journal of Nongken Medicine

摘　　要：目的:研究低碳水化合物饮食联合中等强度有氧运动治疗代谢相关脂肪性肝病的临床疗效。方法:将2020年10月至2021年10月于石河子大学第一附属医院体检中心或消化内科诊断为MAFLD的80例患者为研究对象,将其随机纳入低碳水化合物饮食+中等强度有氧运动组(Lch+AEx组)、低碳水化合物饮食组(Lch组)、中等强度有氧运动组(AEx组)、对照组。在干预前及干预6个月时检测体质量、腰围、血压等人体测量学相关指标及肝功、糖脂代谢相关指标、尿酸、受控衰减参数(CAP)和肝脏硬度值(LSM)并进行分析。结果:受试者中顺利完成6个月临床试验者,Lch+AEx组19例、Lch组15例、AEx组8例、对照组10例。干预6月后,Lch+AEx组患者体重、BMI、腰围、SBP、ALT、AST、TG、TC、LDL-C、2hBG、SUA、CAP及LSM较干预前明显改善(P<0.05),Lch组体重、腰围、SUA、CAP及LSM显著下降(P<0.05),对照组及AEx组患者指标无明显变化。以对照组为参照,Lch+AEx组的体重、BMI、腰围、ALT、AST、LDL-C、CAP及LSM值下降显著(P<0.05);以AEx组为参照,Lch+AEx组患者体重、BMI、腰围、ALT、AST、LDL-C及CAP显著下降(P<0.05);以Lch组为参照,Lch+AEx组患者体重、BMI、LDL-C及CAP显著下降(P<0.05)。结论:低碳饮食配合中等强度有氧运动对于改善代谢相关脂肪性肝病患者肝功、糖脂代谢指标及减少肝脏脂肪沉积明确有效。Objective:To study the clinical effect of low carbohydrate diet combined with moderate intensity aerobic exercise on Metabolic-dysfunction-Associated Fatty Liver Disease.Methods:From October 2020 to October 2021,80 patients with MAFLD diagnosed in the physical examination center of the First Affiliated Hospital of Shihezi University Medical College or the Department of Gastroenterology were selected as the study subjects,and they were randomly divided into low carbon diet+exercise group(Lch+AEx group),low carbon diet group(Lch group),exercise group(AEx group)and control group.Basic information such as body mass,waist circumference,blood pressure,liver function,glycolipid metabolism,uric acid,controlled attenuation parameter(CAP)and liver hardness value(LSM)were measured and analyzed before and 6 months after intervention.Results:Among the subjects who successfully completed the 6-month clinical trial,there were 19 cases in Lch+AEx group,15 cases in Lch group,8 cases in AEx group,and 10 cases in control group.After 6 months of intervention,the body weight,BMI,waist circumference,SBP,ALT,AST,TG,TC,LDL-C,2hBG,SUA,CAP and LSM of Lch+AEx group were improved(P<0.05),while the body weight,waist circumference,SUA,CAP and LSM of Lch group were significantly decreased(P<0.05),while the indexes of control group and AEx group had no significant changes.With the control group as a reference,the values of W,BMI,waist circumference,ALT,AST,LDL-C,CAP and LSM in Lch+AEx group decreased significantly(P<0.05).With the AEx group as a reference,the values of W,BMI,waist circumfer ence,ALT,AST,LDL-C and CAP in Lch+AEx group decreased significantly(P<0.05).Compared with Lch group,the W,BMI,LDL-C and CAP of Lch+AEx group decreased significantly(P<0.05).Conclusion:A low-carbon diet combined with moderate intensity aerobic exercise is clearly effective in improving liver function,glucose and lipid metabolism indicators and reducing liver fat deposition in patients with Metabolic-dysfunction-Associated Fatty Liver Disease.

关 键 词：低碳水化合物饮食 代谢相关脂肪性肝病 中等强度有氧运动 受控衰减参数 

分 类 号：R575.5[医药卫生—消化系统]