熊去氧膽酸與多烯磷脂酰膽堿治療非酒精性脂肪性肝病的臨床效果觀察

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[摘要] 目的 探討熊去氧膽酸與多烯磷脂酰膽堿治療非酒精性脂肪性肝病的臨床效果。方法 收集2012年5月～2013年11月我院住院及門診治療的122例NAFLD患者，按照入院治療的先后順序分為觀察組和對(duì)照組，每組61例。對(duì)照組采用多烯磷脂酰膽堿治療，觀察組采用熊去氧膽酸聯(lián)合多烯磷脂酰膽堿治療，比較兩組總有效率及治療前后肝功能、血脂及肝與脾CT比值。結(jié)果 ①觀察組總有效率為83.61%，對(duì)照組為63.93%，觀察組明顯高于對(duì)照組（P<0.05）。②兩組治療后ALT、AST、γ-GT、TG、TC均明顯低于治療前，HDL-C明顯高于治療前，觀察組治療后肝與脾CT比值明顯高于治療前（P<0.05）。觀察組治療后ALT、AST、γ-GT、TG、TC均明顯低于對(duì)照組，而HDL-C明顯高于對(duì)照組（P<0.05）。結(jié)論 采用熊去氧膽酸與多烯磷脂酰膽堿治療NAFLD的臨床效果明顯優(yōu)于單獨(dú)使用多烯磷脂酰膽堿。

[關(guān)鍵詞] 非酒精性脂肪性肝病；熊去氧膽酸；多烯磷脂酰膽堿

[中圖分類號(hào)] R575.5 [文獻(xiàn)標(biāo)識(shí)碼] B [文章編號(hào)] 1673-9701（2014）11-0040-03

[Abstract] Objective To investigate the clinical effect of ursodeoxycholic acid and polyene phosphatidylcholine of non-alcoholic fatty liver disease. Methods A total of 122 cases of NAFLD patients were collected from May 2012 to November 2013 in our hospital inpatient and outpatient treatment， according to the order of hospitalization they were divided into observation group and control group， there were 61 cases in every group. The control group was given polyene phosphatidylcholine treatment， the observation group was given UDCA combined with polyene phosphatidylcholine treatment. We compared total liver function， blood lipids， liver and spleen CT ratio and efficiency before and after treatment. Results （1） Total efficiency of observation group was 83.61%， the control group was 63.93% the observation group was significantly higher than the control group （P<0.05）. （2） After treatment， ALT， AST， γ-GT， TG， TC of two group were significantly lower than before treatment， HDL-C was significantly higher than before treatment， after treatment， the liver and spleen CT of observation group was significantly higher than pre-treatment CT （P<0.05）. ALT， AST， γ-GT， TG， TC of the observation group after treatment were significantly lower than the control group after treatment， while HDL-C was significantly higher（P<0.05）. Conclusion Ursodeoxycholic acid and polyene phosphatidylcholine NAFLD clinical treatment is better than alone polyene phosphatidylcholine effect.

[Key words] Nonalcoholic fatty liver disease； Ursodeoxycholic acid； Polyene phosphatidylcholine

非酒精性脂肪性肝病（nonalcoholic fatty liver disease，NAFLD）是一種無過量飲酒史和其他明確肝損害因素引起的以彌漫性肝細(xì)胞大泡性脂肪變?yōu)椴±硖卣鞯募膊。愿螌?shí)質(zhì)細(xì)胞脂肪變性及脂肪貯積為主要表現(xiàn)[1]。NAFLD是西方國家的一種常見疾病，在普通人群中的患病率為20%～30%，在肥胖或糖尿病人群中有相對(duì)較高的患病率，能高達(dá)70%～90%[2]。近年來隨著經(jīng)濟(jì)的發(fā)展及生活方式的改變，肥胖及代謝綜合征全球化的流行趨勢，NAFLD發(fā)病率也逐年提高，已經(jīng)成為我國一種常見的慢性肝病，對(duì)人們身體健康造成嚴(yán)重危害，因此積極防治NAFLD對(duì)阻止疾病進(jìn)展及改善預(yù)后有重要的作用[3]。我們采用熊去氧膽酸聯(lián)合多烯磷脂酰膽堿治療61例NAFLD患者，取得了較好的療效，現(xiàn)報(bào)道如下。

1資料與方法

1.1一般資料

收集2012年5月～2013年11月我院住院及門診治療的122例NAFLD患者，診斷標(biāo)準(zhǔn)均參照中華醫(yī)學(xué)會(huì)肝臟病學(xué)分會(huì)脂肪肝和酒精性肝病學(xué)組制定的《非酒精性脂肪性肝病診療指南》。……