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多烯磷脂酰胆碱治疗老年中重度脂肪肝的临床研究 被引量:23

Clinical trial of polyene phosphatidylcholine in the treatment of moderate and severe fatty liver in the elderly
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摘要 目的评价多烯磷脂酰胆碱治疗老年中重度脂肪肝临床疗效及安全性。方法 102例老年中重度脂肪肝按照体重随机分为对照组51例与试验组51例,在2组均给予维持水电解质平衡、抽腹水等常规治疗以及对症治疗的基础上,对照组口服非诺贝特片0.1 g·d^-1和肌苷片0.2 g·d^-1,每日3次;试验组口服非诺贝特片0.1 g·d^-1和多烯磷脂酰胆碱胶囊456 mg·d^-1,每日3次。2组患者一个周期均为28 d,共治疗2个周期。比较2组临床疗效和治疗前后的基质金属蛋白酶-1(TIMP^-1)、瘦素(leptin)水平、肿瘤坏死因子、血清谷丙转氨酶(ALT)、谷草转氨酶(AST)、总胆红素(TBIL)、直接胆红素(DBIL)、白蛋白(ALB)以及药物不良反应发生情况。结果治疗后,对照组临床总有效率为74.51%(38/51例),与试验组的92.16%(47/51例)比较差异有统计学意义(P〈0.05)。治疗后,对照组和试验组的血清基质金属蛋白酶-1分别为(183.46±19.76),(136.41±14.96)ng·m L^-1、瘦素分别为(1.09±0.23),(0.78±0.08)μg·L^-1、肿瘤坏死因子分别为(0.82±0.09),(0.61±0.07)ng·L^-1、谷丙转氨酶(ALT)分别为(70.46±8.19),(56.57±6.72)U·L^-1、谷草转氨酶(AST)分别为(31.78±3.82),(22.54±2.73)U·L^-1、总胆红素分别为(41.95±4.63),(37.13±4.32)μmol·L^-1、直接胆红素分别为(17.57±2.01),(15.68±1.97)μmol·L^-1、白蛋白分别为(31.85±3.30),(36.95±4.21)g·L^-1,组间比较差异有统计学意义(均P〈0.05)。2组的药物不良反应均以眩晕头痛、轻微胃肠道紊乱等为主,试验组与对照组的总药物不良反应发生率分别为5.88%(3/51例),11.76%(6/51例),2组比较差异无统计学意义(P〉0.05)。结论多烯磷脂酰胆碱治疗老年中重度脂肪肝的临床疗效显著,安全性高。 Abstract: Objective To evaluate the efficacy and safety of polyene phosphatidylcholine in the treatment of moderate and severe fatty liver in the elderly . Methods A total of 102 cases with moderate and severe fatty liver in the elderly included were dividing into control group and treatment group with 51 cases in each. The patients in the both groups were given conventional treatments including with the maintainenee of the balance of water electrolytepumping ascites as well as symptomatic treatment. Basis on the above treatments, patients in the control group were orally given fenofibrate tablets 0. 1 g · d ^- 1 and inosine tablets 0. 2 g · d^ - 1 with 3 times a day and patients in the treatment group were received fenofibrate tablets 0. 1 g · d^-1 and multi phosphatidylcholine capsules456 mg · d^-1 by oral administration with 3 times a day . A cycle of treantment were 28 d, a total of 2 cycles for two groups. The clinical efficacy, matrix metalloproteinase tissue inhibitor - 1 (TIMP - 1 ), leptin ( LEP), transforming growth factor a ( TNF - α ), alanine aminotransferase (ALT) , aspartate aminotransferase ( AST), total bilirubin ( TBIL), direct bilirubin (DBIL) ,albumin (ALB) and adverse drug reactions were compared between the two groups. Results The total effective rate treatment group was 92. 16% (47/51), significant higher than that in control group with 74. 51% (38/51) after treatment (P 〈 0. 05 ). The serum matrix metalloproteinase tissue inhibitor - 1 (TIMP - 1 ) in control group and treatment group were ( 183. 46 ± 19. 76 ), ( 136. 41 ±14. 96 )ng · mL^- 1, leptin (LEP) were ( 1.09 ± 0. 23 ), ( 0. 78 ± 0. 08 )μg · L^-1 , transforming growth factor α(TNF -α) were (0. 82 ±0. 09), (0. 61 ±0. 07)ng · L^-1 alanine aminotransferase (ALT) were ( 70. 46 ± 8. 19 ), (56. 57 ±6. 72) U · L^-1, aspartate aminotransferase (AST) were ( 31.78 ± 3. 82 ), (22. 54 ± 2. 73) U · L^- 1, total bilir
作者 吕雪幼 叶国良 LU Xue - you, YE Guo - liang ( Department of Digestive Medicine, Affiliated Hospital of Ningbo University Medical College, Ningbo 315020, Zhejiang Province, China)
出处 《中国临床药理学杂志》 CAS CSCD 北大核心 2016年第15期1370-1373,共4页 The Chinese Journal of Clinical Pharmacology
基金 浙江省医药卫生计划基金资助项目(2011KYA132)
关键词 多烯磷脂酰胆碱 老年中重度脂肪肝 安全性 polyene phosphatidylcholine moderate and severe fatty liver in the elderly safety
作者简介 吕雪幼(1981-),女,主治医师,主要从事消化类疾病的临床与基础研究 通信作者:叶国良,主任医师,硕士生导师,Tel:(0574)87035170,87035170,E—mail:lvxueyouyisheng@163.com
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