罗格列酮治疗非酒精性脂肪肝的临床效果观

目的观察罗格列酮治疗非酒精性脂肪肝（NAFLD）的临床效果。方法将100例NAFLD患者完全随机的方法分为观察组和对照组，各50例。观察组口服罗格列酮4 mg，1次/d；对照组口服二甲双胍片0.5 g，3次/d；2组疗程均为6个月。观察2组治疗前后体重指数、肝功能［丙氨酸转氨酶（ALT）、天冬氨酸转氨酶（AST）、谷氨酰转肽酶（GGT）］、血脂（总胆固醇、三酰甘油）、胰岛素抵抗指数（HOMA IR）及空腹胰岛素（FINS）水平的变化。结果观察组总有效率为84.0%（42/50），对照组总有效率为66.0%（33/50），2组比较差异有统计学意义（P＜0.05）。观察组治疗后体重指数、肝功能（ALT、AST、GGT）、血脂（总胆固醇、三酰甘油）、HOMA IR及FINS水平较治疗前明显改善［（22±7）kg/m2比（28±9）kg/m2；（36±7）U/L比（116±9）U/L，（29±7）U/L比（97±8）U/L，（27±6）U/L比（75±8）U/L；（4.0±1.1）mmol/L比（5.0±1.3）mmol/L，（1.3±0.7）mmol/L比（2.6±1.3）mmol/L；（9±4）mU/L比 （13±9）mU/L，（1.6±1.1）×103比（2.6±1.2）×103］（P＜0.05），与对照组治疗后［分别为（25±7）kg/m2，（71±9）U/L，（66±3）U/L，（62±6）U/L，（3.6±1.7）mmol/L，（1.8±0.7）mmol/L，（11±3）mU/L，（2.1±1.4）×103］比较，差异均有统计学意义（均P＜0.05）。结论罗格列酮能够治疗NAFLD，通过改善靶组织对胰岛素的敏感性，改善NAFLD的胰岛素抵抗，调节血脂，从而减轻NAFLD的肝损害，疗效优于二甲双胍。

Clinical efficacy of rosiglitazone in treatment of nonalcoholic fatty liver disease

ObjectiveTo observe the effect of rosiglitazone in the treatment of nonalcoholic fatty liver disease （NAFLD）. MethodsOne hundred cases of NAFLD were randomly divided into observation group and control group, with 50 cases in each group. The observation group was given oral rosiglitazone and the control group was given oral metformin tablets 0.5 g, 3 times one day; two groups were treated for 6 months. Body mass index（BMI）, Liver function alanine aminotransferase（ALT）,aspartate aminotransferase（AST）, glutamyl transpeptidase （GGT）], blood lipidtotal cholesterol（TC）,triacylglycerol（TG）], insulin resistance index （HOMA IR） and fasting insulin （FINS） levels of two groups before and after treatment were observed. ResultsThe total effective rate of observation group was 84.0% （42/50） and the total effective rate of the control group was 66.0% （33/50）; there was a significant difference between two groups （P〈0.05）. BMI, liver function （ALT,AST, GGT）, blood lipid （TC,TG）, HOMA IR and FINS levels in the two groups after treatment were significantly improved （22±7）kg/m2 vs （28±9）kg/m2;（36±7）U/L vs （116±9）U/L,（29±7）U/L vs （97±8）U/L,（27±6）U/L vs（75±8）U/L;（4.0±1.1）mmol/L vs （5.0±1.3）mmol/L,（1.3±0.7）mmol/L vs （2.6±1.3）mmol/L;（9±4）mU/L vs （13±9）mU/L,（1.6±1.1）×103 vs （2.6±1.2）×103]（P〈0.05）. ConclusionRosiglitazone can improve the resistance to NAFLD of insulin and blood lipid regulation to reduce liver damage NAFLD.