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目的:评价瑞舒伐他汀(可定)联合多烯磷脂酰胆碱(易善复)对非酒精性脂肪肝合并颈动脉粥样硬化斑块患者的临床疗效。方法:选取于2013年1月-2013年12月期间在某院内科就诊108例非酒精性脂肪肝合并有颈动脉粥样硬化斑块的患者,随机分为2组(每组54例),对照组给予控制饮食基础治疗及口服多烯磷脂酰胆碱治疗;观察组即在对照组基础上联合瑞舒伐他汀治疗,疗程为6个月。观察2组治疗前后生化指标改变:丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、γ-谷氨酰转肽酶(γ-GT)、三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白(LDL-C)、高密度脂蛋白(HDL-C)、高敏C-反应蛋白(hs-CRP)。彩色多普勒仪检测2组治疗前后的颈动脉内膜中层厚度(CIMT)及斑块积分变化,肝脏超声影像下脂肪肝病变程度的变化。结果:观察组治疗后ALT、AST、γ-GT、TG、TC、LDL-C、HDL-C、hs-CRP与治疗前比较,差异有统计学意义(P<0.05);对照组治疗后ALT、AST、γ-GT显著降低,有统计学意义(P<0.05);观察组与对照组治疗后比较TG、TC、HDL-C、LDL-C差异有统计学意义(P<0.05)。观察组治疗后CIMT及斑块积分较治疗前显著下降,差异有统计学意义(P<0.05);则对照组差异无统计学意义。2组患者治疗后肝脏超声的改变:2组治疗后分别与治疗前比较肝脏超声分度均有显著差异(Z1=-3.055,P=0.002;Z2=-2.753,P=0.006),而2组治疗后比较无显著差异,无统计学意义(Z=-1.387,P=0.16)。结论:瑞舒伐他汀联合多烯磷脂酰胆碱对非酒精性脂肪肝合并颈动脉粥样硬化斑块患者疗效显著,值得临床推广应用。
OBJECTIVE: To evaluate the clinical efficacy of rosuvastatin combined with polyene phosphatidylcholine (Yi Shan Fu) in non-alcoholic fatty liver disease patients with carotid atherosclerotic plaque. Methods: A total of 108 patients with carotid atherosclerotic plaques with non-alcoholic fatty liver in a hospital from January 2013 to December 2013 were randomly divided into 2 groups (54 in each group) The control group was given basic diet control and oral polyene phosphatidylcholine treatment. The observation group was treated with rosuvastatin on the basis of the control group for 6 months. The changes of biochemical indexes before and after treatment were observed in two groups: ALT, AST, γ-GT, TG, total cholesterol TC), low density lipoprotein (LDL-C), high density lipoprotein (HDL-C) and high-sensitivity C-reactive protein (hs-CRP) The changes of carotid intima-media thickness (CIMT) and plaque integral in both groups before and after treatment were detected by color Doppler imaging. The changes of fatty liver lesions in liver ultrasonography were observed. Results: After treatment, the levels of ALT, AST, γ-GT, TG, TC, LDL-C, HDL-C and hs-CRP in the observation group were significantly different from those before treatment (P < (P <0.05). The difference of TG, TC, HDL-C and LDL-C between the observation group and the control group after treatment was statistically significant (P <0.05). The CIMT and plaque score in observation group decreased significantly compared with those before treatment (P <0.05), but there was no significant difference in control group. The changes of liver ultrasound in the two groups after treatment were significantly different between the two groups (Z1 = -3.055, P = 0.002; Z2 = -2.753, P = 0.006) After treatment there was no significant difference, no statistical significance (Z = -1.387, P = 0.16). Conclusion: Rosuvastatin combined with polyene phosphatidylcholine has a significant therapeutic effect on non-alcoholic fatty liver disease with carotid atherosclerotic plaques and is worthy of clinical application.