2021 年第 6 期 第 16 卷

多烯磷脂酰胆碱胶囊联合阿托伐他汀治疗非酒精性脂肪性肝病的效果及安全性

Efficacy and safety of polyene phosphatidylcholine capsules combined with atorvastatin on the treatment of nonalcoholic fatty liver disease

作者：余建平1张晓强1盛吉芳2

英文作者：Yu Jianping1 Zhang Xiaoqiang1 Sheng Jifang2

单位：1浙江大学附属第二医院余杭院区杭州市余杭区第一人民医院感染科311100；2浙江大学医学院附属第一医院感染科浙江大学科学技术研究院，杭州310003

英文单位：1Department of Infectious Disease Yuhang District the Second Affiliated Hospital Zhejiang University the First People′s Hospital of Yuhang District Hangzhou 311100 China; 2Department of Infectious Disease the First Affiliated Hospital Zhejiang University School of Medicine the SCI/Tech Academy of Zhejiang University Hangzhou 310003 China

关键词：非酒精性脂肪性肝病；多烯磷脂酰胆碱胶囊；阿托伐他汀；肝功能

英文关键词：Nonalcoholicfattyliverdisease;Polyenephosphatidylcholinecapsules;Atorvastatin;Liverfunction

• 摘要：

• 目的 探讨多烯磷脂酰胆碱胶囊联合阿托伐他汀治疗非酒精性脂肪性肝病（NAFLD）的效果及安全性。方法 选择2018年1月至2019年6月杭州市余杭区第一人民医院收治的NAFLD患者82例,应用随机数字表法分为观察组和对照组，各41例。对照组在常规干预基础上口服多烯磷脂酰胆碱胶囊治疗，观察组在对照组基础上联合阿托伐他汀片口服治疗。2组均连续用药6个月。比较2组患者治疗6个月后的临床疗效，治疗前后肝功能指标、血清生化因子和炎症因子水平，以及不良反应发生率。结果 治疗6个月后，对照组临床痊愈6例、显效11例、有效13例、无效11例，观察组临床痊愈12例、显效18例、有效9例、无效2例，观察组临床疗效优于对照组（Z=7.405，P=0.007），总有效率高于对照组［95.1%(39/41)比73.2%（30/41）］（χ2=5.851，P=0.016）。治疗前，2组肝功能指标、血清生化因子和炎症因子水平比较差异均无统计学意义（均P＞0.05）；治疗6个月后，2组血清丙氨酸转氨酶、天冬氨酸转氨酶、碱性磷酸酶、核因子κB、转化生长因子β、高敏C反应蛋白和肿瘤坏死因子α水平均低于治疗前，且观察组均低于对照组［(42±8)U/L比（71±9）U/L，(35±5)U/L比（46±6）U/L，(40±9)U/L比（53±9）U/L，(1.15±0.10)ng/L比（2.29±0.15）ng/L，(3.2±1.5)ng/L比（5.0±1.5）ng/L，(2.2±0.7)mg/L比（3.2±0.7）mg/L，(246±45)ng/L比（329±47）ng/L］（均P<0.05）。2组治疗过程中不良反应发生率比较差异无统计学意义（P=0.236）。结论 多烯磷脂酰胆碱胶囊联合阿托伐他汀治疗NAFLD临床效果较好，并可改善患者肝功能、降低机体炎症反应，且不增加不良反应。

• Objective To investigate the efficacy and safety of polyene phosphatidylcholine capsules combined with atorvastatin on the treatment of nonalcoholic fatty liver disease (NAFLD). Methods From January 2018 to June 2019, 82 patients with NAFLD in the First People′s Hospital of Yuhang District, Hangzhou were randomly divided into observation group and control group, with 41 cases in each group. The control group was treated with polyene phosphatidylcholine capsules orally on the basis of conventional intervention, and the observation group was treated with atorvastatin tablets orally on the basis of control group. Both groups were treated for 6 months. The clinical efficacy after 6 months of treatment, liver function indexes, serum levels of biochemical factors and inflammatory factors before and after treatment, and the incidence of adverse reactions were compared between the two groups. Results After 6 months of treatment, there were 6 cases clinically cured, 11 cases markedly effective, 13 cases effective and 11 cases ineffective in the control group, and 12 cases clinically cured, 18 cases markedly effective, 9 cases effective and 2 cases ineffective in the observation group. The clinical efficacy in the observation group was better than that in the control group (Z=7.405, P=0.007), and the total effective rate in the observation group was higher than that in the control group ［95.1%(39/41) vs 73.2%(30/41)］(χ2=5.851, P=0.016). Before treatment, there were no significant differences in liver function indexes, serum biochemical factors and inflammatory factors between the two groups (all P>0.05); after 6 months of treatment, the serum alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, nuclear factor-κB, transforming growth factor-β, high-sensitivity C-reactive protein and tumor necrosis factor-α levels in the two groups were lower than those before treatment, and those in the observation group were lower than the those in the control group ［(42±8)U/L vs (71±9)U/L, (35±5)U/L vs (46±6)U/L, (40±9)U/L vs (53±9)U/L, (1.15±0.10)ng/L vs (2.29±0.15)ng/L, (3.2±1.5)ng/L vs (5.0±1.5)ng/L, (2.2±0.7)mg/L vs (3.2±0.7)mg/L, (246±45)ng/L vs (329±47)ng/L］ (all P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups during treatment(P=0.236). Conclusion Polyene phosphatidylcholine capsules combined with atorvastatin has significant clinical effect on the treatment of NAFLD, and can improve liver function and reduce inflammatory reaction of organism, without increasing adverse reactions.