水飞蓟宾葡甲胺联合多烯磷脂酰胆碱治疗酒精性脂肪肝患者初步临床研究

目的 探讨水飞蓟宾葡甲胺联合多烯磷脂酰胆碱治疗酒精性脂肪肝患者的疗效。方法 选取本院2014年10月~2015年10月诊治的酒精性脂肪肝患者164例,采用随机数字表法分为两组,对照组患者82例采用多烯磷脂酰胆碱治疗,观察组患者82例采用水飞蓟宾葡甲胺联合多烯磷脂酰胆碱治疗,比较两组患者治疗前后血脂指标、肝功能指标、影像学检查指标的变化。结果 在治疗3个月末,观察组患者血清总胆固醇、甘油三酯、低密度脂蛋白胆固醇、丙氨酸氨基转移酶、天冬氨酸氨基转移酶、谷氨酰转肽酶分别为（3.8±0.6） mmol/L、（1.3±0.2）mmol/L、（2.3±0.2） mmol/L、（47.3±7.2）U/L、（41.7±8.0） U/L、（46.5±7.3） U/L,显著低于对照组的（4.4±0.5）mmol/L、（1.5±0.2） mmol/L、（2.8±0.3） mmol/L、（58.1±12.4） U/L、（55.6±9.9） U/L和（67.8±10.1） U/L（P<0.01）;观察组高密度脂蛋白胆固醇为（1.3±0.2） mmol/L,显著高于对照组的（1.1±0.2） mmol/L（P<0.01）;观察组影像学检查提示重度、中度、轻度、正常肝脏表现者分别为1例（1.2%）、11例（13.4%）、33例（40.2%）、37例（45.1%）,显著好于对照组的6例（7.3%）、19例（23.2%）、45例（54.9%）、12例（14.6%,P<0.01）。结论 水飞蓟宾葡甲胺联合多烯磷脂酰胆碱治疗酒精性脂肪肝可明显改善酒精性脂肪肝患者血脂指标和肝功能指标。

Preliminary clinical trials on silybin meglumine combined with phosphatidylcholine in treatment of patients with alcoholic fatty liver

Objective To investigate the curative effect of silybin meglumine combined with phosphatidylcholine in treatment of patients with alcoholic fatty liver （AFL）. Methods 164 patients with AFL were recruited in our hospital between October 2014 and October 2015. Patients were randomly divided into two groups, and 82 patients were treated with phosphatidylcholine as control group,and another 82 patients were treated with silybin meglumine combined with phosphatidylcholine as observation group. Indexes of blood lipid,liver function and imaging examination were compared before and after treatment between the two groups. Results At the end of three month treatment,serum total cholesterol,triglyceride,low density lipoprotein cholesterol,alanine aminotransferase,aspartate aminotransferase and glutamyltranspeptidase levels in observation group were（3.8±0.6） mmol/L,（1.3±0.2） mmol/L,（2.3±0.2） mmol/L,（47.3±7.2） U/L,（41.7±8.0） U/L and（46.5±7.3） U/L,respectively,significantly lower than those in the control group （4.4±0.5） mmol/L,（1.5±0.2） mmol/L,（2.8±0.3） mmol/L,（58.1±12.4） U/L,（55.6±9.9） U/L and（67.8±10.1） U/L,respectively,P<0.01];serum high density lipoprotein cholesterol level in observation group was（1.3±0.2） mmol/L,which was significantly higher than that in the control group（1.1±0.2） mmol/L,P<0.01];Imaging examination showed that the numbers of severe,moderate,mild fatty liver and normal liver manifestation in observation group were 1 case（1.2%）,11 cases （13.4%）,33 cases （40.2%） and 37 cases（45.1%）,respectively,significantly better than those in the control group 6 cases （7.3%）,19 cases （23.2%）,45 cases （54.9%） and 12 cases （14.6%）,respectively,P<0.01]. Conclusion Silybin meglumine combined with phosphatidylcholine can significantly improve blood lipid and liver function indexes in patients with AFL.