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目的探讨普罗布考对非酒精性脂肪性肝病(NAFLD)的治疗作用和机制。方法 64例NAFLD患者按患者就诊顺序编号,依随机数据表分为实验组(n=33)和对照组(n=31),实验组给予控制饮食和普罗布考治疗3月;对照组给予控制饮食和多种维生素护肝治疗。分别于治疗前后抽血检测空腹血糖(FPG)、血脂和丙氨酸氨基转移酶(ALT)、胰岛素(INS)并计算胰岛素抵抗指数(HOMA-IR)、肿瘤坏死因子-α(TNF-α)、白介素-8、白介素-18(IL-18),比较各指标治疗前后的差异及治疗后组间差异。结果两组治疗后血酯、ALT较治疗前下降,差异有统计学意义(P<0.05~0.001),两组治疗比较,实验组下降更明显(P<0.05~0.01);两组治疗后HOMA-IR较治疗前降低,治疗前后比较差异有统计学意义(P<0.05~0.001);而治疗组下降更为明显,差异有统计学意义(P<0.05);实验组治疗前后TNF-α、IL-8、IL-18比较差异均有统计学意义(P<0.01~0.001),治疗后实验组较对照组下降明显,差异有统计学意义(P<0.01)。结论普罗布考可有效地降低NAFLD的血脂浓度和TNF-α、IL-8、IL-18等炎性因子表达,进而调节肝脏脂肪代谢和改善肝组织炎症坏死,促进肝功能恢复。
Objective To investigate the therapeutic effect and mechanism of probucol on non-alcoholic fatty liver disease (NAFLD). Methods Sixty-four patients with NAFLD were enrolled according to the patient’s order of treatment. The patients were divided into experimental group (n = 33) and control group (n = 31) according to randomized data table. The experimental group was given control diet and probucol for 3 months. Diet and multi-vitamin liver care. Fasting plasma glucose (FPG), serum lipids, alanine aminotransferase (ALT) and insulin (INS) were measured before and after treatment. HOMA-IR, TNF- , Interleukin-8 and interleukin-18 (IL-18) were measured before and after treatment. The differences between before and after treatment were compared between groups. Results The blood levels of ALT and ALT in both groups decreased significantly after treatment compared with before treatment (P <0.05-0.001). Compared with the two groups, the decline of ALT was more obvious in the experimental group (P <0.05-0.01). After treatment, HOMA -IR before treatment was lower than before treatment, the difference was statistically significant before and after treatment (P <0.05 ~ 0.001), while the treatment group decreased more significantly, the difference was statistically significant (P <0.05); experimental group before and after treatment TNF- The difference of IL-8 and IL-18 between the two groups was statistically significant (P <0.01-0.001). After treatment, the experimental group decreased significantly compared with the control group (P <0.01). Conclusion Probucol can effectively reduce the blood fat concentration of NAFLD and the expression of inflammatory factors such as TNF-α, IL-8 and IL-18, so as to regulate hepatic fat metabolism, improve hepatic inflammation, necrosis and promote liver function recovery.