非诺贝特联合双环醇治疗非酒精性脂肪性肝病患者肝组织PPARγ2 mRNA水平变化

doi:10.3969/j.issn.1672-5069.2021.01.016

摘要/Abstract

摘要： 目的探讨应用非诺贝特联合双环醇治疗非酒精性脂肪性肝病(NAFLD)患者的疗效及肝组织过氧化物酶体增殖物激活受体γ₂(PPARγ₂)水平变化。方法 2018年2月～2019年12月我院收治的NAFLD患者66例,采用随机数字表法分为对照组33例和观察组33例,分别给予双环醇片口服或在此基础上给予非诺贝特片口服治疗,两组均治疗3个月。肝穿刺获得肝组织,采用PCR法检测肝组织PPARγ₂ mRNA水平,采用化学发光免疫分析法检测血清肿瘤坏死因子-α(TNF-α)和白介素-6(IL-6)水平,采用免疫比浊法检测血清超敏C反应蛋白(hs-CRP)水平,使用FC500型流式细胞仪检测外周血CD3+、CD4+和CD8+细胞百分比。结果在治疗结束时,观察组总有效率为97.0%,显著高于对照组的66.7%(P<0.05);观察组肝组织PPARγ₂mRNA相对水平为(1.5±0.1),显著高于对照组【(1.1±0.2),P<0.05】;观察组血清TNF-α水平为(26.4±3.1)pg/mL,显著低于对照组【(32.8±6.9)pg/mL,P<0.05】,血清IL-6水平为(35.9±4.9)ng/L,显著低于对照组【(46.4±5.8)ng/L,P<0.05】,血清hs-CRP水平为(5.1±1.4)mg/L,显著低于对照组【(8.4±1.9)mg/L,P<0.05】;观察组外周血CD3+细胞百分比为(80.2±11.5)%,显著高于对照组【(60.5±7.7)%,P<0.05】,外周血CD4+细胞百分比为(44.7±5.8)%,显著高于对照组【(31.4±4.8)%,P<0.05】,CD4+/ CD8+细胞比值为(1.5±0.4),显著高于对照组【(1.1±0.3),P<0.05】。结论联合应用非诺贝特和双环醇治疗NAFLD患者有短期疗效,可能与提高了肝组织PPARγ₂水平,降低了血清炎症细胞因子水平有关,值得进一步研究。

关键词: 非酒精性脂肪性肝病, 非诺贝特, 双环醇, 过氧化物酶体增殖物激活受体γ₂, 细胞因子, 治疗

Abstract: Objective To explore the efficacy of fenofibrate and bicyclol combination in the treatment of patients with non-alcoholic fatty liver diseases (NAFLD) and its influence on hepatic peroxisome proliferator-activated receptor gammaγ₂ (PPARγ₂) mRNA level. Methods 66 patients with NAFLD were admitted to our hospital between February 2018 and December 2019, and were randomly divided into control group (n=33) and observation group (n=33), receiving bicyclol or bicyclol and fenofibrate combination for three months. The curative effect in the two groups after treatment were compared. The liver biopsies were performed, and hepatic PPARγ₂ messenger ribonucleotide (mRNA) were assayed by PCR. Serum cytokines and peripheral blood T lymphocyte subsets were compared. Results At the end of the treatment, the total effective rate in the observation group was 97.0%, which was much higher than that in the control group (66.7%, P<0.05); the relative level of PPARγ₂ mRNA in liver tissues in the observation group was (1.5±0.1), significantly higher than in the control; serum tumor necrosis factor-α (TNF-α) level was (26.4±3.1) pg/mL, significantly lower than , serum IL-6 level was (35.94.9) ng/L, significantly lower than (46.45.8) ng/L, P<0.05], and serum high-sensitivity C-reactive protein (hs-CRP) level was (5.1±1.4) mg/L, much lower than in the control; the percentage of peripheral blood CD3+ cells was (80.2±11.5)%, significantly higher than , the percentage of peripheral blood CD4+ cells was (44.7±5.8) %, significantly higher than , and the ratio of CD4+/CD8+ cells was (1.5±0.4), significantly higher than in the control.Conclusion The oral administration of fenofibrate and bicyclol combination in the treatment of patients with NAFLD has a short-term efficacy, which might be related to the increased hepatic PPARγ2 mRNA levels and the reduction of serum cytokine levels.

Key words: Nonalcoholic fatty liver diseases, Fenofibrate, Bicyclol, Peroxisome proliferator-activated receptor γ2, Cytokines, Therapy

李钊, 黄赞松, 李繁. 非诺贝特联合双环醇治疗非酒精性脂肪性肝病患者肝组织PPARγ₂mRNA水平变化[J]. 实用肝脏病杂志, 2021, 24(1): 59-62.

Li Zhao, Huang Zansong , Li Fan. Application of fenofibrate and bicyclol combination in treatment of patients with non-alcoholic fatty liver diseases and changes of hepatic PPARγ₂[J]. Journal of Practical Hepatology, 2021, 24(1): 59-62.

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非诺贝特联合双环醇治疗非酒精性脂肪性肝病患者肝组织PPARγ₂mRNA水平变化

Application of fenofibrate and bicyclol combination in treatment of patients with non-alcoholic fatty liver diseases and changes of hepatic PPARγ₂

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