复方甘草酸苷联合非诺贝特治疗代谢相关性脂肪性肝病患者疗效及其对脂代谢的影响*

doi:10.3969/j.issn.1672-5069.2023.05.012

摘要/Abstract

摘要： 目的探讨应用复方甘草酸苷联合非诺贝特治疗代谢相关性脂肪性肝病(MAFLD)患者的疗效及对脂代谢和肝功能的影响。方法 2019年12月～2021年12月我院收治的MAFLD患者74例,被随机分为对照组37例和观察组37例,分别给予复方甘草酸苷或复方甘草酸苷联合非诺贝特治疗24 w。使用Fibrotouch弹性成像仪检测肝脏脂肪受控衰减参数(CAP)和肝硬度测定(LSM),从常规检测结果获得脂肪肝指数(FLI)。结果在治疗24 w末,观察组血清高密度脂蛋白水平为(1.7±0.4)mmol/L,显著高于对照组【(1.4±0.3)mmol/L,P＜0.05】,而血清总胆固醇、甘油三酯和低密度脂蛋白水平分别为(4.7±0.7)mmol/L、(2.2±0.4)mmol/L和(2.0±0.3)mmol/L,显著低于对照组【分别为(5.5±0.9)mmol/L、(3.4±0.7)mmol/L和(2.6±0.4)mmol/L,P＜0.05】;观察组血清ALT、AST和GGT水平分别为(50.5±4.9)U/L、(56.5±6.8)U/L和(92.0±11.5)U/L,与对照组【分别为(53.6±5.8)U/L、(50.4±7.7)U/L和(90.3±18.6)U/L】比,差异无统计学意义(P>0.05);观察组CAP和FLI分别为(281.2±16.7)dB/m和(19.9±4.5),均显著低于对照组【分别为(316.1±29.5)dB/m和(23.2±5.0),P＜0.05】,而两组LSM比较,无显著性差异【(8.4±1.7)kPa对(8.2±1.3)kPa,P>0.05】。结论应用复方甘草酸苷联合非诺贝特治疗MAFLD患者能提高短期临床疗效,调节脂代谢,促进肝功能恢复,降低肝脏脂肪含量,有一定的临床应用价值。

Abstract: Objective The aim of this study was to investigate the short-term efficacy of glycyrrhizin and fenofibrate combination in the treatment of patients with metabolic associated fatty liver disease (MAFLD). Methods 74 patients with MAFLD were recruited in our hospital between December 2019 and December 2021, and were randomly divided into control and observation group, with 37 cases in each, receiving oral glycyrrhizin or glycyrrhizin and fenofibrate combination therapy for 24 weeks. The controlled attenuation parameter (CAP) and liver stiffness measurement (LSM) were detected by Fibrotouch, and the fatty liver index (FLI) was calculated. Results At the end of 24 weeks of treatment, serum high-density lipoprotein level in the observation group was (1.7±0.4)mmol/L, significantly higher than [(1.4±0.3)mmol/L, P＜0.05], while serum total cholesterol, triglyceride and low density lipoprotein levels were(4.7±0.7)mmol/L,(2.2±0.4)mmol/L and (2.0±0.3)mmol/L, all significantly lower than [(5.5±0.9)mmol/L, (3.4±0.7)mmol/L and (2.6±0.4)mmol/L, respectively, P＜0.05] in the control; serum alanine aminotransferase, aspartate aminotransferase and gamma-glutamyl transferase levels in the observation group were (50.5±4.9)U/L,(56.5±6.8)U/L and (92.0±11.5)U/L, all not significantly different compared to [(53.6±5.8)U/L, (50.4±7.7)U/L and (90.3±18.6)U/L, respectively, P＜0.05] in the control group; the CAP and the FLI in the observation group were (281.2±16.7)dB/m and (19.9±4.5), both significantly lower than [(316.1±29.5)dB/m and (23.2±5.0), respectively, P＜0.05] in the control, while there was no significant difference as respect to the LSM between the two groups [(8.4±1.7)kPa vs.(8.2±1.3)kPa, P>0.05]. Conclusion The application of glycyrrhizin and fenofibrate combination in treatment of patients with MAFLD is efficacious, which might regulate lipid metabolism, improve liver function recovery and reduce liver fat content.

Key words: Metabolic associated fatty liver disease, Glycyrrhizin, Fenofibrate, Controlled attenuation parameter, Fatty liver index, Therapy

罗良德, 苏建明, 任成果, 申红. 复方甘草酸苷联合非诺贝特治疗代谢相关性脂肪性肝病患者疗效及其对脂代谢的影响^*[J]. 实用肝脏病杂志, 2023, 26(5): 650-653.

Luo Liangde, Su Jianming, Ren Chengguo, et al. Oral glycyrrhizin and fenofibrate administration in treatment of patients with metabolic associated fatty liver diseases[J]. Journal of Practical Hepatology, 2023, 26(5): 650-653.

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复方甘草酸苷联合非诺贝特治疗代谢相关性脂肪性肝病患者疗效及其对脂代谢的影响^*

Oral glycyrrhizin and fenofibrate administration in treatment of patients with metabolic associated fatty liver diseases

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