维生素D联合水飞蓟宾胶囊治疗非酒精性脂肪性肝病临床效果及其对血清纤溶酶原激活剂抑制物、组织蛋白酶D影响  

Clinical effect of vitamin D combined with silybin capsule in the treatment of non-alcoholic fatty liver disease and its effect on serum plas-minogen activator inhibitor-1 and cathepsin D

作　　者：饶静 张汝 黄旭东 蔡弟 盛琛 杨传留 陈敬 RAO Jing;ZHANG Ru;HUANG Xu-dong;CAI Di;SHENG Chen;YANG Chuan-liu;CHEN Jing(Department of Pharmacy,Huainan East Hospital Group General Hospital,Huainan 232001,China;Invasive Technology Department,Huainan East Hospital Group General Hospital,Huainan 232001,China;Department of Respiratory Medicine,Huainan East Hospital Group General Hospital,Huainan 232001,China;Department of Oncology,Huainan East Hospital Group General Hospital,Huainan 232001,China)

机构地区：[1]淮南东方医院集团总医院药学部,安徽淮南232001 [2]淮南东方医院集团总医院介入科,安徽淮南232001 [3]淮南东方医院集团总医院呼吸内科,安徽淮南232001 [4]淮南东方医院集团总医院肿瘤科,安徽淮南232001

出　　处：《临床军医杂志》2023年第6期582-586,共5页Clinical Journal of Medical Officers

基　　金：安徽省科学技术项目(2021048)。

摘　　要：目的探讨维生素D联合水飞蓟宾胶囊治疗非酒精性脂肪性肝病的临床效果及其对血清纤溶酶原激活剂抑制物(PAI-1)、组织蛋白酶D(CTSD)的影响。方法选取淮南东方医院集团总医院自2019年1月至2022年1月收治的96例非酒精性脂肪性肝病患者为研究对象。根据随机信封法将患者随机分入A组、B组、C组,每组各32例。A组患者接受常规治疗,每天1次口服阿托伐他汀10 mg,进行适量运动和饮食控制,戒烟戒酒,限制脂肪摄入。B组患者在A组基础上加用水飞蓟宾胶囊口服治疗,每次2粒,每天3次。C组患者在B组基础上辅以维生素D胶囊口服治疗,每天1粒。患者均持续性治疗3个月。比较3组患者治疗前后的体质量指数、腰臀比、肝功能指标、血脂代谢水平、PAI-1、CTSD,以及治疗效果、不良反应发生情况。结果B组和C组患者的治疗有效率均高于A组,C组患者的治疗有效率高于B组,差异有统计学意义(P<0.05)。治疗后,3组患者的体质量指数、腰臀比、谷丙转氨酶、谷草转氨酶、谷酰转肽酶、总胆固醇、甘油三酯、高密度脂蛋白、PAI-1、CTSD均低于治疗前,B组和C组患者的体质量指数、腰臀比、谷丙转氨酶、谷草转氨酶、谷酰转肽酶、总胆固醇、甘油三酯、高密度脂蛋白、PAI-1、CTSD均低于A组,C组患者的体质量指数、腰臀比、谷丙转氨酶、谷草转氨酶、谷酰转肽酶、总胆固醇、甘油三酯、高密度脂蛋白、PAI-1、CTSD均低于B组,差异有统计学意义(P<0.05)。3组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论维生素D联合水飞蓟宾胶囊治疗非酒精性脂肪性肝病可显著提高治疗效果,改善肝功能和脂代谢,降低血清PAI-1、CTSD水平。Objective To investigate the clinical effect of vitamin D combined with silybin capsule in the treatment of non-alcoholic fatty liver disease and the effect on serum plas-minogen activator inhibitor-1(PAI-1)and cathepsin D(CTSD).Methods A total of 96 patients with non-alcoholic fatty liver disease admitted to Huainan East Hospital Group General Hospital from January 2019 to January 2022 were selected as the study subjects.Patients were randomly divided into group A,group B and group C according to random envelope method,with 32 cases in each group.Patients in group A received conventional treatment,including oral atorvastatin 10 mg once a day,moderate exercise and diet control,smoking and alcohol cessation,and limiting fat intake.Group B was additionally treated with silybin capsules orally on the basis of group A,2 capsules each time,3 times a day.Group C was supplemented with oral vitamin D capsules on the basis of group B,1 capsule a day.All patients continued treatment for 3 months.Body mass index,waist-tohip ratio,liver function index,lipid metabolism level,PAI-1,CTSD,therapeutic effect and occurrence of adverse reactions were compared between the three groups before and after treatment.Results The therapeutic effective rate of group B and group C was higher than that of group A,and that of group C was higher than that of group B,the difference was statistically significant(P<0.05).After treatment,the body mass index,waist-to-hip ratio,alanine aminotransferase,aspartate aminotransferase,glutamyl transpeptide,total cholesterol,triglyceride,high density lipoprotein,PAI-1 and CTSD in three groups were all lower than before treatment,the body mass index,waist-to-hip ratio,alanine transaminase,aspartate transaminase,glutamyl transpeptide enzyme,total cholesterol,triglyceride,high density lipoprotein,PAI-1 and CTSD of group B and group C were all lower than those of group A,the body mass index,waist-to-hip ratio,alanine aminotransferase,aspartate aminotransferase,glutamyl transpeptide enzyme,total cholesterol,trig

关 键 词：维生素D 水飞蓟宾胶囊 非酒精性脂肪性肝病 纤溶酶原激活剂抑制物 组织蛋白酶D 

分 类 号：R575.5[医药卫生—消化系统] R256.42[医药卫生—内科学]