硫普罗宁与罗格列酮联合治疗非酒精性脂肪性肝病疗效观察

目的：观察硫普罗宁与罗格列酮联合治疗非酒精性脂肪性肝病（NAFLD）疗效及其对调节性T细胞的影响。方法100例NAFLD患者随机分为治疗组和对照组（n=50），治疗组给予硫普罗宁肠溶片200 mg 口服，每日三次和罗格列酮片2 mg 口服，每日二次治疗，对照组给予护肝片1.5 g 口服，每日三次治疗。两组均治疗3个月，比较其疗效和对肝功能、血脂、胰岛素抵抗指数（HOMA-IR）及调节性T细胞的影响。结果两组患者治疗后血清谷丙转氨酶（ALT）、谷草转氨酶（AST）水平均明显降低，差异均有统计学意义（t分别=31.81、17.94、20.31、14.86，P均＜0.05），治疗组治疗后血清三酰甘油（TG）、总胆固醇（TC）、低密度脂蛋白胆固醇（LDL-C）和HOMA-IR水平均有明显下降，高密度脂蛋白胆固醇（HDL-C）水平明显升高，差异均有统计学意义（t分别=6.84、8.81、7.59、7.41、4.67， P均＜0.05），而对照组仅血清TG、TC下降，差异均有统计学意义（t分别=4.71、4.96，P均＜0.05）；治疗组治疗后脂肪肝B超分级程度明显低于对照组，差异均有统计学意义（Z=2.56，P＜0.05），治疗组的总有效率（92.00％）明显高于对照组（67.10％），差异亦有统计学意义（χ2分别=10.07，P＜0.05）；治疗组明显提高CD4＋CD25＋/CD4＋比率和CD4＋CD25＋Foxp3/CD4＋比率，差异均有统计学意义（t分别=4.78、6.74，P均＜0.05）。结论硫普罗宁与罗格列酮联合治疗NAFLD在降低血脂水平、减轻胰岛素抵抗和改善肝脏功能方面疗效明显。

Effect of tiopronin combined with rosiglitazone on non-alcoholic fatty liver disease

Objective To observe the efficacy of tiopronin combined with rosiglitazone on non-alcoholic fatty liver disease （NAFLD） and its influence on regulatory T cells. Methods A total of 100 patients with NAFLD were randomly divided into treatment group and control group with 50 cases in each. The treatment group were treated with tiopronin 200 mg Bid and rosiglitazone 2 mg Bid. The control group were treated with liver-protecting tablet 1.5 g Tid. The efficacy, liver function, blood fat, insulin resistance index （HOMA-IR） and regulatory T cells were observed at 3 months after treatment. Results The levels of serum alanine aminotransferase and aspartate aminotransferase of two groups were significantly lower than those pre-treatment （t=31.81,17.94,20.31,14.86,P〈0.05）. After treatment, the levels of serum triglycerides, total cholesterol, low-density lipoprotein cholesterol and HOMA-IR in treatment group were significantly decreased, and high-density lipoprotein cholesterol levels were significantly increased, the differences were statistically significant （t=6.84,8.81,7.59,7.41,P〈0.05 ） while only serum TG and TC in the control group was significantly decrease （t=4.71,4.96,P〈0.05）. After treatment, the fatty liver degree of type-B ultrasonic in treatment group was significantly lower than that in control group （Z=2.56,P〈0.05）. The total efficiency of the treatment group （92.00%） was significantly higher than that of the control group （67.10%）, the difference was statistically significant （χ2=10.07,P〈0.05）. Compared with control group, the CD4＋CD25＋/CD4＋ratio and CD4＋ CD25＋ Foxp3/CD4＋ ratio were significantly increased in the treatment group, the differences were statistically significant （t=4.78,6.74,P〈0.05）. Conclusion The effect of tiopronin combined with rosiglitazone on NAFLD has notable curative in reducing blood lipit and insulin resistance and improving＆amp;nbsp;liver function.