摘要
目的观察阿托伐他汀治疗非酒精性脂肪性肝病(nonalcoholic fatty liver disease,NAFLD)的临床疗效。方法 179例患者随机分为3组,低剂量组口服阿托伐他汀,10 mg/d;高剂量组口服阿托伐他汀,20 mg/d;对照组使用水林佳胶囊,105 mg/次,3次/d。共治疗16周。对比3组治疗前及治疗16周时腹部计算机体层摄影(computed tomo-graphy,CT)肝脾比值变化,治疗前及用药后8、16周血清总胆固醇(cholesterol,TC)、甘油三酯(glycerin trilaurate,TG)、高密度脂蛋白胆固醇(high density lipoprotein cholesterol,HDL-C)、低密度脂蛋白胆固醇(low density lipoprotein choles-terol,LDL-C)、血、尿粪常规、天门冬氨酸转氨酶(aspartate aminotransferase,AST)、谷丙转氨酶(alanine aminotrans-ferase,ALT)、γ-谷氨酰转肽酶(γ-glutamy transpeptidase,γ-GT)、碱性磷酸酶(alkaline phosphatase,ALP)、间接胆红素(indirect bilirubin,IBIL)、肌酐(creatinine,Cr)、肌酸激酶(creatine kinase,CK)及心电图的变化情况,随时记录治疗期间出现的不良反应。结果低剂量组、高剂量组和对照组的总有效率分别为93.75%、92.98%及91.38%,无统计学差异(P>0.05)。阿托伐他汀能有效降低患者TC、TG及LDL的水平,提高HDL,且高剂量组的效果优于低剂量组。安全性方面,高剂量组试验过程中有少数病例出现了消化道反应,调整为饭后服药或予对症处理后均消失,3例转氨酶轻度升高,1例CK轻度升高;低剂量组有1例转氨酶轻度升高;水林佳胶囊组未出现不良反应。实验室安全性指标(包括血、尿、粪常规、肝功能、肾功能、心电图)均未出现与药物相关的异常变化。结论阿托伐他汀可安全用于非酒精性脂肪性肝病合并高脂血症的治疗,且高剂量组疗效优于低剂量组。
Objective To observe the curative effects of atorvastatin on nonalcoholic fatty liver disease（NAFLD）.Methods A total of 179 NAFLD patients were randomly divided into three groups.The low-dose group was administrated with atorvastatin 10 mg per day,the high-dose group was administrated with atorvastatin 20 mg per day,and the control group was administrated with silibinin capsule 105 mg per time,3 times per day.Before treatment,8 and 16 weeks after the treatment,the liver to spleen CT ratio,cholesterol（TC）,glycerin trilaurate（TG）,high density lipoprotein cholesterol（HDL-C）,low density lipoprotein cholesterol（LDL-C）,creatine kinase（CK）,liver function indexes including alanine aminotransferase（ALT）,aspartate aminotransferase（AST）,alkaline phosphatase（ALP）,γ-glutamy transpeptidase（γ-GT）,indirect bilirubi（IBIL）,renal function indexes including creatinine（Cr）,routine indexes of blood,urine and stool and electrocardiogram（ECG） were detected respectively.Adverse effect was also observed.Results The total effective rate in the low-dose,high-dose and control groups were 93.75% and 92.98% and 91.38% respectively without significant difference（P0.05）.Lipid lowering effect was better,TC,TG and LDL-C were significantly decreased,and HDL-C was increased in atorvastatin treatment group,and better in high-dose group than in low-dose group.In high-dose group,several cases had digestive reaction which disappeared by drug administration after the meal and symptomatic therapy,3 cases had slight increase of aminotransferase,and 1 case had slight increase of CK.In low-dose group,1 case had slight increase of aminotransferase.No adverse event was observed in the control group.In all the three groups,no abnormal drug-related change in laboratory indexes including routine blood,urine and stool,liver function,renal function and ECG was observed.Conclusion Atorvastatin can treat NAFLD with hyperlipemia safely.High dose（20 mg/d） of atorvastatin has better curative effect than low dose（10 mg/d）.
出处
《华南国防医学杂志》
CAS
2011年第6期494-497,共4页
Military Medical Journal of South China
关键词
阿托伐他汀
非酒精性脂肪性肝病
水林佳
Atorvastatin
Non-alcoholic fatty liver disease
Silibinin capsule
