阿托伐他汀治疗非酒精性脂肪性肝病的疗效观察

目的 观察阿托伐他汀治疗非酒精性脂肪性肝病(NAFLD)的疗效及安全性.方法 选择72例非酒精性脂肪性肝病患者,共68例患者按规定要求完成试验.所有患者基线丙氨酸转氨酶(ALT)及总胆固醇(TC)水平均高于正常值.随机分为治疗组38例、对照组30例.予治疗组患者阿托伐他汀10 mg/d(TC≤6.5 mmol/L)或20 mg/d(TC＞6.5 mmol/L)口服.对照组患者则不予给药.记录两组患者基线水平及治疗6个月时的症状积分、体重指数(BMI)、血TC水平、ALT水平及B超测量肝密度.结果 治疗组基线期和6个月时的症状积分分别为11.05±1.29和6.08±0.87,差异有统计学意义(t=1.96,P＜0.05).经6个月治疗.治疗组中11例患者ALT水平恢复正常,对照组中仅2例患者ALT水平恢复正常,差异有统计学意义(P＜0.05).治疗组基线及6个月时的TC水平分别为(6.65±0.5)和(5.4±0.5)mmol/L,两者间差异有统计学意义(t=1.72,P＜0.05).治疗组基线及6个月时的BMl分别为(26.8±2.9)和(26.4±2.8)kg/m~2,对照组则分别为(26.5±2.3)和(26.4±2.2)kg/m~2,两者间差异均无统计学意义(P值均＞0.05).治疗组及对照组基线及6个月时的B超肝密度分级差异亦无统计学意义(P值均＞0.05).试验中未观察到明显不良反应.结论 NAFLD患者经阿托伐他汀治疗后,血清ALT水平及TC水平均显著下降.合并高胆固醇血症的NAFLD患者选用阿托伐他汀治疗安全有效.

Effects of atorvastatin on treatment of patients with non-alcoholic fatty liver disease

Objective To evaluate the efficacy and safety of atorvastatin in treatment of patients with non-alcoholic fatty liver disease(NAFLD).Methods Of 72 patients with NAFLD6,8 patients with elevated alanine transaminase(ALT)and cholesterol levels at baseline had completed the study.The patients were randomly divided into treatment trial group(n=38)and control group(n=30,ithout any treatment).The patients in trial group were orally received 10 or 20 mg of atorvastatin daily according to basal serum cholesterol levels being≤or＞6.5 mmol/L,respectively.The parameters including body mass index,serum cholesterol level and ALT level were tested and liver density was assessed by echography at baseline and 6 months after treatment.Results There was a significant difference in syndrome scores between baseline and 6 months after treatment[(11.05±1.29)vs.(6.08±0.87)]in trial group(t=1.96,P＜0.05).Six months after treatment,11 patients in trial group were presented with normal ALT levels.whereas only 2 patients in control group had normal ALT levels (P＜0.05).There was a significant differenee in cholesterol level between baseline and 6 months after treatment[(6.6±0.54)ramol/L vs.(5.4±0.5)mmol/L]in trial group(t=1.72,P＜0.05).In addition,there was no differenee in body mass index between baseline and 6 months after treatment both in rial group[(26.8±2.9)kg/m~2 vs.(26.4±2.8)kg/m~2]and control group[(26.5±2.3)kg/m~2 vs.(26.4±2.2)kg/m2~](P＞0.05).There was no significant difference in liver density of two groups before and after treatment(P＞0.05).No side effect was reported.Conclusions Serum ALT and cholesterol levels are reduced significantly in all patients treated with atorvastatin.It is effective and safe for atorvastatin in treating NAFLD patients with hypercholesterolemia.