摘要
目的探讨应用多烯磷脂酰胆碱(PPC)治疗中重度非酒精性脂肪性肝病(NAFLD)患者的疗效,并探讨其护肝机制。方法 2013年1月~2016年12月我科诊治的中重度NAFLD患者90例,采用随机数字表法将其分为3组,每组30例。对照组接受常规治疗,观察一组在常规治疗基础上加予PPC胶囊口服,观察二组加予PPC注射液静脉滴注,连续治疗8周。结果在观察结束时,观察一组和观察二组肝脏B超评分分别为(3.2±0.7)分和(3.3±0.6)分,显著低于对照组的(4.5±0.6)分,肝/脾CT比值分别为(0.9±0.2)和(0.9±0.1),显著高于对照组的【(0.7±0.2),P<0.05】;观察一组总胆固醇(TC)、甘油三酯(TG)和低密度脂蛋白(LDL-C)分别为(4.8±0.6)mmol/L、(2.0±0.2)mmol/L和(3.0±0.2)mmol/L,观察二组分别为(4.7±0.6)mmol/L、(1.9±0.3)mmol/L和(2.9±0.3)mmol/L,均显著低于对照组的(5.1±0.5)mmol/L、(2.2±0.2)mmol/L和(3.3±0.3)mmol/L,而高密度脂蛋白(HDL-C)分别为(1.4±0.4)mmol/L和(1.4±0.3)mmol/L,显著高于对照组的(1.3±0.3)mmol/L(P<0.05);观察一组血清肿瘤坏死因子-α(TNF-α)、单核细胞趋化蛋白-1(MCP-1)和核转录因子-κB(NF-κB)水平分别为(10.3±2.6)ng/ml、(4.6±0.7)ng/ml和(9.4±1.1)ng/ml,观察二组分别为(9.8±2.3)ng/ml、(4.4±0.6)ng/ml和(9.6±1.4)ng/ml,均显著低于对照组的(22.5±3.6)ng/ml、(9.3±1.1)ng/ml和(16.3±2.5)ng/ml,而血红素加氧酶-1(HO-1)、谷胱甘肽过氧化物酶(GSH-Px)和超氧化物歧化酶(SOD)水平均显著高于对照组(P<0.05)。结论口服或静脉给予PPC治疗NAFLD患者近期有效,可促进中重度NAFLD患者血脂代谢,其机制可能与抑制炎症和氧化应激反应有关。
Objective To investigate the efficacy of polyene phosphatidylcholine（PPC） in patients with moderate-to-severe nonalcoholic fatty liver disease（NAFLD）.Methods A total of 90 patients with moderate-to-severe NAFLD were recruited in our hospital between January 2013 and December 2016,and were randomly divided into three groups by computer-generated randomized numbers.The patients in control received routine treatment,and those in observation group one received PPC orally,and in observation group two received PPC intravenously for eight weeks.Results At the end of the observation,the ultrasound scores in observation group one and two were（3.2±0.7） and（3.3±0.6）,much lower than（4.5±0.6） in the control,and the liver/spleen CT ratios were（0.9±0.2） and（0.9±0.1）,much higher than（0.7±0.2） in the control（P〈0.05）;serum levels of total cholesterol（TC）,triglyceride（TG） and low density lipoprotein（LDL-C） in observation group one were（4.8 ±0.6）mmol/L,（2.0 ±0.2）mmol/L and（3.0 ±0.2）mmol/L,and in observation group two were（4.7 ±0.6）mmol/L,（1.9 ±0.3）mmol/L and（2.9±0.3）mmol/L,much lower than（5.1±0.5）mmol/L,（2.2±0.2）mmol/L and（3.3±0.3） mmol/L,while high density lipoprotein（HDL-C） were（1.4 ±0.4）mmol/L and（1.4 ±0.3）mmol/L,respectively,much higher than（1.3 ±0.3）mmol/L in the control（P〈0.05）;serum tumor necrosis factor-α（TNF-α）,monocyte chemotactic protein-1（MCP-1） and nuclear factor-κB（NF-κB） levels in observation group one were（10.3 ±2.6）ng/ml,（4.6 ±0.7） ng/m L and（9.4 ±1.1）ng/ml,and in group two were（9.8 ±2.3）ng/m L,（4.4 ±0.6）ng/ml and（9.6 ±1.4）ng/ml,much lower than（22.5±3.6）ng/ml,（9.3±1.1）ng/ml and（16.3 ±2.5）ng/ml in the control,while serum heme oxygenase-1（HO-1）,glutathione peroxidase（GSH-Px） and superoxide dismutase（SOD） levels were much higher than those in the control（P〈0.05）.Conclusion There is no significant difference in the eff
作者
周志菁
黄永东
Zhou Zhiqing;Huang Yongdong(Department of Emergency,People＇s Hospital,Dongfang 572600,Hainan Province,China)
出处
《实用肝脏病杂志》
CAS
2018年第5期733-736,共4页
Journal of Practical Hepatology
基金
海南省自然科学基金资助项目(编号:201508316)
关键词
非酒精性脂肪性肝病
多烯磷脂酰胆碱
炎性因子
氧化应激
治疗
Non-alcoholic fatty liver
Polyene phosphatidylcholine
Inflammatory cytokines
Oxidative stress
Therapy
