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[目的]研究多烯磷脂酰胆碱联合二甲双胍治疗对非酒精性脂肪性肝病(NAFLD)患者肝纤维化,血浆抵抗素以及胰岛素抵抗的影响。[方法]选取我院在2015年1月~2017年1月收治的122例NAFLD患者,将患者按照不同治疗方式分成2组(每组61例),对照组患者采用多烯磷脂酰胆碱,观察组患者采用多烯磷脂酰胆碱联合二甲双胍治疗。观察不同治疗方式对患者肝纤维化指标、血浆抵抗素以及胰岛素抵抗的影响。[结果]治疗后观察组患者各项肝纤维化指标为[(90.36±27.54)mg/L、(85.48±26.57)μg/L、(45.21±24.14)μg/L、(85.49±26.84)μg/L],显著低于对照组肝纤维化各项指标值[(144.36±48.75)mg/L、(114.31±35.24)μg/L、(76.24±37.57)μg/L、(123.51±36.58)μg/L、(P<0.05)];2组患者治疗前后Wt、BMI、WC、TG、TC、HDL-C、LDL-C变化情况比较差异无统计学意义(P>0.05);FPG、FINS、ALT、AST、Resistin、HOMA-IR各指标在治疗前比较差异无统计学意义(P>0.05),治疗后观察组患者各指标值为[(4.11±1.14)mmol/L、(8.27(3.21~11.84))mIU/L、(31.51±6.47)U/L、(29.31±7.54)U/L、(12.54±3.14)μg/L、(2.64(1.79~5.12))],显著低于对照组各指标值[(6.23±2.34)mmol/L、(9.95(3.30~11.81))mIU/L、(52.61±8.76)U/L、(37.54±8.21)U/L、(16.62±4.48)μg/L、(3.24(1.71~4.87)),(P<0.05)],2组患者治疗期间未出现不良反应情况。[结论]多烯磷脂酰胆碱联合二甲双胍治疗具有缓解NAFLD患者肝纤维化作用,改善NAFLD患者胰岛素抵抗程度以及降低NAFLD患者血浆抵抗素的表达水平。
[Objective] To investigate the effect of polyene phosphatidylcholine combined with metformin on liver fibrosis, plasma resistin and insulin resistance in patients with nonalcoholic fatty liver disease (NAFLD). [Methods] A total of 122 patients with NAFLD admitted from January 2015 to January 2017 in our hospital were divided into two groups (61 cases in each group) according to different treatment methods. Patients in the control group were treated with polyene phosphatidylcholine, Patients in the observation group were treated with polyene phosphatidylcholine and metformin. To observe the different treatment of liver fibrosis indicators, plasma resistin and insulin resistance. [Results] The indexes of liver fibrosis in the observation group after treatment were (90.36 ± 27.54) mg / L, (85.48 ± 26.57) μg / L, (45.21 ± 24.14) μg / L and (85.49 ± 26.84) μg / L was significantly lower than that of the control group [(144.36 ± 48.75) mg / L, (114.31 ± 35.24) μg / L, (76.24 ± 37.57) μg / L, (123.51 ± 36.58) μg / (P <0.05). There was no significant difference in the changes of Wt, BMI, WC, TG, TC, HDL-C and LDL-C between the two groups before and after treatment , AST, Resistin and HOMA-IR had no significant difference before treatment (P> 0.05). After treatment, the indexes in the observation group were (4.11 ± 1.14) mmol / L and (8.27 ± 3.21-11.84 ) was significantly lower than that of the control group (P <0.01). The mean IU of the control group was (31.51 ± 6.47) U / L, (29.31 ± 7.54) U / L, (6.23 ± 2.34) mmol / L, (9.95 ± 3.30-11.81) mIU / L, 52.61 ± 8.76 U / L, 37.54 ± 8.21 U / L and 16.62 ± 4.48 μg / (3.24 (1.71 ~ 4.87)), (P <0.05)], no adverse reactions occurred in the two groups during treatment. [Conclusion] Polyene phosphatidylcholine combined with metformin can relieve hepatic fibrosis in patients with NAFLD, improve the degree of insulin resistance in NAFLD patients and decrease the expression of plasma resistin in NAFLD patients.