复方二氯醋酸二异丙胺联合门冬氨酸鸟氨酸治疗老年性非酒精性脂肪性肝炎的效果研究

Efficacy of compound diisopropylamine dichloroacetate combined with ornithine aspartate in treatment of non-alcoholic steatohepatitis in the elderly

摘要:

目的 探讨复方二氯醋酸二异丙胺联合门冬氨酸鸟氨酸治疗老年性非酒精性脂肪性肝炎(NASH)的效果。方法 选取2019年1月至2019年12月于四川省林业中心医院治疗住院的老年性NASH患者95例,根据随机数表法分为对照组与观察组,每组各46例。对照组给予阿托伐他汀治疗,观察组在对照组的基础上给予复方二氯醋酸二异丙胺联合门冬氨酸鸟氨酸进行治疗。比较2组患者的肝功能指标、血脂指标、超声影像学评分、非酒精性脂肪性肝病活动度积分(NAS)、炎性因子及不良反应发生情况。采用SPSS 26.0统计学软件进行数据分析。根据数据类型,组间比较采用独立样本t检验或χ²检验。结果 与对照组相比,治疗后观察组肝功能指标丙氨酸氨基转移酶[(53.29±6.84)和(65.73±7.25)U/L]、天门冬氨酸氨基转移酶[(34.61±4.27)和(45.73±5.12)U/L]及γ-谷氨酰转移酶 [(41.25±3.59)和(64.74±5.52)U/L] 显著降低(均P＜0.05),血脂指标总胆固醇[(4.12±0.64)和(4.87±0.66)mmol/L]、甘油三酯[(1.42±0.31)和(1.63±0.42)mmol/L]及低密度脂蛋白胆固醇[(2.27±0.61)和(3.04±0.59)mmol/L]显著降低(均P＜0.05),超声影像学评分[(6.18±1.34)和(7.25±1.46)分]及NAS积分[(3.27±0.54)和(3.85±0.73)分]显著降低(均P＜0.05),血清中白细胞介素-6 [(109.43±11.87)和(129.75±10.96)μg/L]、肿瘤坏死因子-α[(51.26±6.05)和(63.18±6.72)μg/L]及转化生长因子-β[(6.03±1.92)和(8.45±2.21)μg/L]显著降低(均P＜0.05)。2组患者不良反应发生率比较,差异无统计学意义(P＞0.05)。结论 复方二氯醋酸二异丙胺联合门冬氨酸鸟氨酸辅助治疗老年性NASH的效果显著,具有一定的临床应用价值。

Abstract:

Objective To investigate the effect of compound diisopropylamine dichloroacetate combined with ornithine aspartate in the treatment of non-alcoholic steatohepatitis (NASH) in the elderly. Methods A total of 95 elderly patients with NASH hospitalized in Sichuan Forestry Central Hospital from January 2019 to December 2019 were prospectively recruited and then randomly divided into control group and observation group, with 46 cases in each group. The control group was treated with atorvastatin, and the observation group was treated with compound diisopropylamine dichloroacetate combined with ornithine aspartate on the basis of atorvastatin. The indicators of liver function, blood lipid, ultrasonic imaging score, NASH activity score (NAS), inflammatory factors and adverse reactions were compared between the 2 groups. SPSS statistics 26.0 was used for data analysis. According to the data types, independent sample t test or Chi-square test was employed for intergroup comparison. Results After treatment, the observation group had significantly lower indicators in liver function, including alanine aminotransferase [(53.29±6.84) vs (65.73±7.25) U/L], aspartate aminotransferase [(34.61±4.27) vs (45.73±5.12) U/L] and γ-glutamyltransferase [(41.25±3.59) vs (64.74±5.52) U/L] (all P<0.05), decreased blood lipid indicators, such as total cholesterol [(4.12±0.64) vs (4.87±0.66) mmol/L], triglyceride [(1.42±0.31) vs (1.63±0.42) mmol/L] and low-density lipoprotein cholesterol [(2.27±0.61) vs (3.04±0.59) mmol/L] (all P<0.05), reduced ultrasound imaging score [(6.18±1.34) vs (7.25±1.46)] and NAS score [(3.27±0.54) vs (3.85±0.73)](both P<0.05), and lower inflammatory factors, that is, serum interleukin-6 [(109.43±11.87) vs (129.75±10.96) μg/L], tumor necrosis factor-α [(51.26±6.05) vs (63.18±6.72) μg/L) and transforming growth factor-β [(6.03±1.92) vs (8.45±2.21) μg/L) (all P<0.05) when compared with the control group. There was no significant difference in the incidence of adverse reactions between the 2 groups (P>0.05). Conclusion Compound diisopropylamine dichloroacetate combined with ornithine aspartate shows effective efficacy in the adjuvant treatment of NASH in the elderly, and has a certain clinical value in clinical practice.