【摘要】 目的观察吡格列酮联合非药物治疗对非酒精性脂肪性肝病(NAFLD)的临床疗效。方法 64例NAFLD患者随机分成非药物组和联合组,每组32例。非药物组接受中等程度热量限制及中等量有氧运动治疗,联合组接受吡格列酮+中等程度热量限制及中等量有氧运动治疗。检测并记录患者治疗前及治疗3、6个月后的体重指数(BMI)、天门冬胺酸转胺酶(ALT)、-谷氨酰转肽酶(-GT)、肝脏B超、肝脏CT、空腹血糖(FPG)、空腹胰岛素(FNS)、胰岛素抵抗指数(HOMA-IR)、甘油三脂(TG)、总胆固醇(TC)、高密度脂蛋白(HDL-C);对比两组治疗3、6个月的疗效;观察治疗期间不良反应的发生情况。结果非药物组治疗6个月BMI和FNS较治疗前降低(P<0.05)。联合组治疗后3、6个月的BMI、ALT、-GT、FPG、FNS、HOMA-IR、TG、TC、HDL-C及肝/脾CT比值较治疗前改善(P<0.05)。联合组治疗3个月及6个月的总有效率均高于同期的非药物组(34.4%vs 12.5%,81.3%vs 21.9%,均P<0.05)。治疗期间,联合组仅1例女性患者发生双下肢轻度水肿。结论吡格列酮联合非药物治疗可有效改善NAFLD及合并代谢综合征的多项临床指标,该治疗方法安全、有效。更多还原

【Abstract】 Objective To evaluate the therapeutic efficacy of pioglitazone combined with non-drug treatment on nonalcoholic fatty liver disease(NAFLD). Methods A total of 64 patients with NAFLD were enrolled in the study. The patients were divided randomly into 2 groups of 32 patients each. Patients in non-drug theatment groups received moderate caloric restriction and moderate aerobic exercise therapy. Drug treatment group received pioglitazone combined with the non-drug therapy. Clinical parameters, including body mass index(BMI), aspartate aminotransferase(ALT), - glutamyl endopeptidase(-GT), liver/spleen ratio, fasting plasma glucose(FPG), fasting insulin(FNS), insulin resistance index(HOMA-IR), triglycerides(TG), total cholesterol(TC), and high density lipoprotein(HDL-C), were documented before and 3 and 6 months after treatment. The effectiveness was compared between the two groups. The adverse reactions were observed during the treatment and followup period. Results Treatment with pioglitazone combined with non-drug therapy produced a significant improvement in BMI, ALT, -GT, liver/spleen ratio, FPG, FNS, HOMA-IR, TG, TC, and HDL-C both 3 and 6 months later(P<0.05); whereas treatment with non-drug therapy produced a significant decrease in BMI and FNS 6 months later(P<0.05). The total effective rates in pioglitazone group were significantly higher than that in non-drug group on both 3 and 6 months after treatment(34.4% vs 12.5% for 3 month, P<0.05; 81.3% vs 21.9%, P<0.05). Mild lower extremity edema occurred in 1 patient in pioglitazone group during the follow-up period. Conclusion Pioglitazone combined with non-drug therapy led to multiple clinical indicator improvement in NAFLD patients, which was a safe and effective treatment for NAFLD.更多还原