两种调脂药物对高脂血症性脂肪肝治疗的实验性研究.

目的探讨不同作用机制的调脂药(非诺贝特和辛伐他汀)对高脂血症性脂肪肝的作用.方法高脂食饵性喂养诱导大鼠高脂血症性脂肪肝模型.分别给予非诺贝特、辛伐他汀治疗,观察肝指数、肝功能,血脂、肝脂、血清及肝组织过氧化脂质(MDA)含量及组织学的变化.结果非诺贝特显著降低血脂,分别为TC(mmol/L)1.80±0.20与2 10±0.33,TG(mmol/L)0.76±0.18与1.09±0.31、血清及肝组织MDA含量(nmol/ml)分别3.97±0.57与6.89±1.22和75.22±20.88与106.69±15.60,但ALT、ALP、肝脂、肝指数却显著升高,肝组织学呈重度脂肪变;辛伐他汀显著降低血脂、肝脂、血清及肝组织MDA含量,对肝功能无影响,肝组织学接近正常.结论非诺贝特虽可显著降低血脂,但却加重肝内脂质沉积,不宜用于高脂血症性脂肪肝的治疗.辛伐他汀显著降低血脂及肝脂,降低脂质过氧化,,对肝功能无影响,可较安全、有效地用于高脂血症脂肪肝的治疗.

Different serum lipid adjustment drugs for the treatment of hyperlipidemic fatty liver

OBJECTIVE: To research the effect of different serum lipid adjustment drugs, Simvastatin and Fenofibrate, on hyperlipidemic fatty liver. METHODS: The rat models of hyperlipidemic fatty liver induced by high fat diet were treated with Fenofibrate and Simvastatin respectively to investigate the change of the liver index, liver function, the serum and liver lipid, MDA, and pathologic histology. RESULTS: The liver index and the content of triglyceride (TC1.80 +/-0.20/2.10+/-0.33), total cholesterol (TG 0.76+/-0.18/1.09+/-0.31), MDA both in the serum and the liver in the model group were significantly higher than those in control group. Slight or moderate hepatic steatosis was observed in model group. Fenofibrate decreased serum triglyceride, total cholesterol, and MDA both in serum and liver significantly, but increased the ALT, ALP, liver index, liver lipids, and finally leading to severe hepatic steatosis. Simvastatin lowered the level of lipid and MDA both in serum and liver, and liver histology was improved nearly to normal. Moreover, little side effect on the liver was observed. CONCLUSIONS: Simvastatin can be applied for prevention and treatment of hyperlipidemic fatty liver safely and effectively, while Fenofibrate can not.