实用肝脏病杂志 ›› 2020, Vol. 23 ›› Issue (2): 215-218.doi: 10.3969/j.issn.1672-5069.2020.02.017

• 非酒精性脂肪性肝病 • 上一篇    下一篇

匹伐他汀与阿托伐他汀治疗非酒精性脂肪性肝病患者疗效比较*

王丽娟, 朱兵兵, 胡敏华, 杨丽, 石莉红, 胡健薇   

  1. 710021 西安市 西安医学院(王丽娟,胡敏华,杨丽,石莉红,胡健薇); 空军军医大学第一附属医院检验科(朱兵兵)
  • 收稿日期:2019-05-17 出版日期:2020-03-10 发布日期:2020-04-20
  • 作者简介:王丽娟,女,33岁,医学硕士,讲师。E-mail:jojowlj@163.com
  • 基金资助:
    陕西省卫生与计划生育委员会重点学科建设项目(编号:16hlxk13)

Comparison of efficacy pitavastatin and atorvastatin in treatment of patients withnon-alcoholic fatty liver disease

Wang Lijuan, Zhu Bingbing, Hu Minhua, et al   

  1. Xi'an Medical College , Xi'an 710021, Shaanxi Province China
  • Received:2019-05-17 Online:2020-03-10 Published:2020-04-20

摘要: 目的 探讨匹伐他汀与阿托伐他汀治疗非酒精性脂肪性肝病(NAFLD)患者血脂和胰岛素抵抗指数的变化。方法 将98例NAFLD患者随机分为观察组49例和对照组49例。在对照组,给予阿托伐他汀,而给予观察组匹伐他汀,连续治疗6个月。采用放射免疫法检测血清胰岛素和C-肽(C-P),计算稳态模式评估法-胰岛素抵抗指数( HOMA-IR),采用双抗体夹心ELISA法检测血清肿瘤坏死因子-α(TNF-α)。结果 治疗后,观察组血总胆固醇、甘油三脂和低密度脂蛋白胆固醇水平分别为(3.8±1.2)mmol/L、(2.3±0.6)mmol/L和(2.1±0.5)mmol/L,显著低于对照组【(4.7±1.3)mmol/L、(2.9±0.7)mmol/L和(2.6±0.4)mmol/L,P<0.05】,观察组血高密度脂蛋白胆固醇水平为(1.4±0.2)mmol/L,显著高于对照组【(1.2±0.3)mmol/L,P<0.05】;观察组血清丙氨酸氨基转移酶、天冬氨酸氨基转移酶和谷氨酰转肽酶水平分别为(47.4±14.1)U/L、(42.3±8.6)U/L和(52.1±7.5)U/L,显著低于对照组【分别为(61.2±19.2)U/L、(56.9±9.2)U/L和(69.6±6.4)U/L,P<0.05】;观察组血清TNF-α和C-P水平分别为(3.3±1.2)ng/L和(3.2±0.9)ng/L,显著低于对照组【分别为(4.1±1.1)ng/L和(4.5±0.6)ng/L,P<0.05】,而两组HOMA-IR变化无显著性统计学差异(P>0.05)。结论 匹伐他汀具有降脂、抗炎和改善IR作用,显示出良好的治疗NAFLD患者前景。

关键词: 非酒精性脂肪性肝病, 匹伐他汀, 阿托伐他汀, 血脂, 稳态模式评估法-胰岛素抵抗指数

Abstract: Objective The purpose of this study was to investigate the efficacy pitavastatin and atorvastatin in treatment of patients with non-alcoholic fatty liver disease (NAFLD). Methods 98 patients with NAFLD were randomly divided into observation and control group, with 49 patients in each. The patients in the control group received atorvastatin, and those in the observation group received pivastatin for 6 months. Serum insulin, C-peptide (C-P) and tumor necrosis factor-α(TNF-α) levels were assayed and homeostasis model assessment-insulin resistance index (HOMA-IR) was calculated. Results At the end of treatment, serum total cholesterol, triglyceride and low density lipoprotein cholesterin levels in the observation group were (3.8±1.2) mmol/L, (2.3±0.6) mmol/L and (2.1±0.5) mmol/L,significantly lower than [(4.7±1.3) mmol/L, (2.9±0.7) mmol/L and (2.6±0.4) mmol/L, respectively, P<0.05], while serum high density lipoprotein cholesterin level was (1.4±0.2) mmol/L, significantly higher than [(1.2±0.3) mmol/L, P<0.05] in the control; serum alanine aminotransferase, aspartate aminotransferase and γ-glutamyltransferase levels were (47.4±14.1)U/L,(42.3±8.6)U/L and (52.1±7.5)U/L, significantly lower than 【(61.2±19.2)U/L,(56.9±9.2)U/L and(69.6±6.4)U/L, respectively, P<0.05】 in the control; serum TNF-α and C-P levels were (3.3±1.2)ng/L and (3.2±0.9)ng/L, significantly lower than 【(4.1±1.1)ng/L and (4.5±0.6)ng/L, P<0.05】 in the control, while there was no significantly difference of HOMA-IR in the two groups (P>0.05). Conclusion The pivastatin administration has a good role of reducing lipids, anti-inflammatory reaction and improving IR in patients with NAFLD, which needs further investigation.

Key words: Non-alcoholic fatty liver disease, Pitavastatin, Atorvastatin, Lipids, Homeostasis model assessment-insulin resistance index