关键词: 非酒精性脂肪性肝炎, 匹伐他汀, 多烯磷脂酰胆碱, 治疗

Abstract: Objective The aim of this study was to investigate the short-term clinical efficacy of pitavastatin and polyene phosphatidyl choline combination in the treatment of patients with nonalcoholic steatohepatitis (NASH). Methods 46 patients with NASH were enrolled in our hospital between January 2020 and August 2021, and were divided randomly into control (n=22) and observation group (n=24), receiving polyene phosphatidyl choline or pitavastatin and polyene phosphatidyl choline combination treatment for six months. Serum total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) levels were routinely detected, and the homeostasis model assessment-insulin resistance index (HOMA-IR) was calculated. Serum tumor necrosis factor-α (TNF-α), interleukin-10 (IL-10) and high-sensitivity C-reactive protein (hs-CRP) levels were detected by ELISA. Serum ALT, AST and γ-glutamyltransferase (GGT) levels were obtained. Serum insulin-like growth factor 1 (IGF-1) level was detected by radioimmunoassay. Results At the end of the six month treatment, serum TC, TG and LDL-C levels in the combination group were (4.7±0.5)mmol/L, (2.1±0.4)mmol/L and (2.9±0.5)mmol/L, all significantly lower than [(5.8±0.4)mmol/L, (4.5±0.6)mmol/L and (4.3±0.4)mmol/L, respectively, P<0.05], while serum HDL-C level was (1.8±0.3)mmol/L, significantly higher than [(1.0±0.3)mmol/L, P<0.05] in the control; serum ALT, AST and GGT levels were (53.5±6.9)U/L, (45.2±5.6)U/L and (66.7±3.9)U/L, all significantly lower than [(59.4±6.7)U/L, (49.1±5.5)U/L and (79.3±3.7)U/L, respectively, P<0.05] in the control; the HOMA-IR was (2.2±0.4), much lower than [(2.7±0.5), P<0.05], while serum adiponectin and IGF-1 levels were (11.9±0.8)mg/L and (0.4±0.1)μg/L, both significantly higher than [(9.2±0.8)mg/L and (0.2±0.1)μg/L, respectively, P<0.05] in the control group; serum TNF-α, IL-10 and hs-CRP levels were (3.5±0.5)ng/L, (27.5±5.2)ng/L and (4.1±0.8)mg/L, all not significantly different as compared to [(3.6±0.4)ng/L, (26.9±4.9)ng/L and (4.2±0.9)mg/L] in the control group (P>0.05). Conclusion The administration of pitavastatin and polyene phosphatidyl choline combination in the treatment of patients with NASH could reduce blood lipid levels and improve liver function normalization, which might be related to the reduction of insulin resistance.

Key words: Nonalcoholic steatohepatitis, Pitavastatin, Polyene phosphatidyl choline, Therapy