多烯磷脂酰胆碱联合二甲双胍和非诺贝特治疗NAFLD患者血清Pygo2和血脂水平变化

目的探讨应用多烯磷脂酰胆碱联合二甲双胍和非诺贝特治疗非酒精性脂肪性肝病(NAFLD)患者血清人尾肢同源蛋白2(Pygo2)和血脂水平的变化。方法2015年3月~2019年6月我院收治的NAFLD患者64例,被随机分为对照组32例和观察组32例。给予对照组二甲双胍片和非诺贝特胶囊口服治疗,观察组在此治疗的基础上加用多烯磷脂酰胆碱口服,两组均连续治疗12周。采用放射免疫分析法检测血清透明质酸(HA)和层黏蛋白(LN)水平,采用ELISA法检测血清Pygo2、高迁移率族蛋白B1(HMGB1)和白细胞介素-17(IL-17)。结果在治疗结束时,观察组血甘油三酯(TG)水平为(1.8±0.1)mmol/L,显著低于对照组【(2.7±0.4)mmol/L,P<0.05】,总胆固醇(TC)水平为(4.6±0.4)mmol/L,显著低于对照组【(5.8±0.6)mmol/L,P<0.05】,而血高密度脂蛋白胆固醇(HDL-C)水平为(1.9±0.5)mmol/L,显著高于对照组【(1.5±0.4)mmol/L,P<0.05】;观察组血清丙氨酸氨基转移酶(ALT)水平为(28.4±3.2)U/L,显著低于对照组【(35.9±4.1)U/L,P<0.05】,天冬氨酸氨基转移酶(AST)水平为(22.1±2.0)U/L,显著低于对照组【(32.6±3.4)U/L,P<0.05】,血清HMGB1水平为(13.7±1.5)μg/L,显著低于对照组【(20.2±2.4)μg/L,P<0.05】,IL-17水平为(75.6±7.8)pg/mL,显著低于对照组【(90.7±10.2)pg/mL,P<0.05】;观察组血清HA水平为(84.5±9.2)mg/L,显著低于对照组【(117.6±10.3)mg/L,P<0.05】,LN水平为(91.2±10.2)μg/L,显著低于对照组【(108.7±11.3)μg/L,P<0.05】,Pygo2水平为(37.5±4.1)μg/L,显著低于对照组【(42.4±5.0)μg/L,P<0.05】。结论在运动和饮食控制的基础上,应用多烯磷脂酰胆碱联合二甲双胍和非诺贝特治疗可显著改善NAFLD患者脂代谢,抑制炎症反应和肝纤维化程度,短期临床疗效显著。

Short-term efficacy of polyene phosphatidylcholine combined with metformin and fenofibrate in patients with NAFLD

Objective The aim of this study was to investigate the s short-term efficacy of polyene phosphatidylcholine combined with metformin and fenofibrate in patients with nonalcoholic fatty liver disease (NAFLD). Methods 64 patients with NAFLD were recruited in our hospital between March 2015 and June 2019, and were randomly divided into control (n=32) and observation group (n=32). The patients in the control group were treated orally with metformin and fenofibrate capsules, while those in the observation group were additionally treated with polyene phosphatidylcholine capsules at the base of medicine mentioned above. The observation lasted for 12 weeks. Serum hyaluronic acid (HA), laminin (LN), high mobility group protein (HMGB1) and interleukin -17 (IL-17) were detected.Results At the end of 12 week observation, blood triglyceride (TG) level was (1.8±0.1)mmol/L, significantly lower than 【(2.7±0.4)mmol/L, P＜0.05】, total cholesterol (TC) level was (4.6±0.4)mmol/L, significantly lower than 【(5.8±0.6)mmol/L, P＜0.05】, while blood high density lipoprotein cholesterol (HDL-C) level was(1.9±0.5)mmol/L, significantly higher than 【(1.5±0.4)mmol/L, P＜0.05】 in the control; serum ALT level was (28.4±3.2)U/L, much lower than 【(35.9±4.1)U/L, P＜0.05】, AST level was (22.1±2.0)U/L, much lower than 【(32.6±3.4)U/L, P＜0.05】, serum HMGB1 level was (13.7±1.5)μg/L, significantly lower than 【(20.2±2.4)μg/L, P＜0.05】, and serum IL-17 level was (75.6±7.8)pg/mL, significantly lower than 【(90.7±10.2)pg/mL, P＜0.05】 in the control group; serum HA level was (84.5±9.2)mg/L, significantly lower than 【(117.6±10.3)mg/L, P＜0.05】, LN level was (91.2±10.2)μg/L, significantly lower than 【(108.7±11.3)μg/L, P＜0.05】, and serum Pygo2 level was (37.5±4.1)μg/L, much lower than 【(42.4±5.0)μg/L, P＜0.05】 in the control. Conclusion The administration of polyene phosphatidylcholine combined with metformin and fenofibrate tablets might obviously improve blood lipid metabolism and inhibit inflammatory reactions in patients with NAFLD, which needs long-term investigation.