熊去氧胆酸治疗非酒精性脂肪肝30例临床观察(1)
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[摘要] 目的 观察熊去氧胆酸治疗非酒精性脂肪肝的疗效。方法 非酒精性脂肪肝患者分为治疗组30例，应用熊去氧胆酸钠胶囊(优思弗胶囊)250mg，每日3次，口服，疗程为6个月。对照组30例，应用多烯磷脂胆碱胶囊(易善复胶囊)456mg，每日3次，口服，疗程为6个月。观察治疗前后肝脏B超、生化指标、肝脏大小和症状变化。结果 治疗后肝脏B超、生化学指标、症状明显改善，与易善复比较无统计学意义，无明显不良反应。结论 熊去氧胆酸治疗非酒精性脂肪肝安全有效，值得临床推广使用。
[关键词] 熊去氧胆酸；非酒精性脂肪肝
[中图分类号]R575.5 [文献标识码] B [文章编号]1673-9701(2011)24-85-02
The Therapeutic Effect of Ursodeoxycholic Acid in Treatment of Nonalcoholic Fatty Liver：A Clinical Observation of 30 Cases
YANG Yide HOU Wei
Taizhou Municipal Hospital in Zhejiang Province，Taizhou 318000，China
[Abstract] Objective To investigate the efficacy of ursodeoxycholic acid in the treatment of nonalcoholic fatty liver. Methods Sixty cases with non-alcoholic fatty liver were divided into two groups with 30 cases in each， the treatment group of 30 cases which received ursodeoxycholic acid capsules of 250mg， 3 times a day， oral ingestion， treatment for 6 months，and control group of 30 cases which received polyene phosphorylcholine capsule (Essentiale capsules)of 456mg， 3 times a day oral ingestion， treatment for 6 months. The change of B-scan liver， biochemical parameters， liver size and the symptoms were xamined before and after the treatment. Results Essentiale，liver ultrasonography，biochemical indicators，symptoms of treatment group significantly improved after the treatment .There was no statistical significance between the two groups.ursodeoxycholic acid was no significant adverse reaction. Conclusion Using ursodeoxycholic acid and treating non-alcoholic fatty liver is very safe and effective， worthy in clinical widely.
[Key words] Ursodeoxycholic acid；Nonalcoholic fatty liver
非酒精性脂肪性肝病(NAFLD)是一种与胰岛素抵抗(insulin resistance，IR)和遗传易感密切相关的代谢应激性肝脏损伤疾病，其病理学改变与酒精性肝病(ALD)相似，但患者无过量饮酒史，疾病谱包括非酒精性单纯性脂肪肝(nonalcoholic simple fatty liver，NAFL)、非酒精性脂肪性肝炎(NASH)及其相关肝硬化和肝细胞癌[1]。NAFLD是影响21世纪全球公共健康的重要原因之一，亦是我国愈来愈重视的慢性肝病问题[2]。2010年3月～2011年3月我院应用熊去氧胆酸(ursodeoxycholicacid，UCDA)治疗非酒精性脂肪肝30例，效果较好，现报道如下。
1 资料与方法
1.1 病例选择
患者60例，男21例，女39例，年龄18～60岁，平均41.5岁，诊断标准符合2010年中华医学会肝病学分会脂肪肝和酒精性肝病学组制定的《非酒精性脂肪性肝病诊疗指南》[2]。入选标准：①无饮酒史或饮酒折合乙醇量<140g/周(女性<70g/周)； ②除外病毒性肝炎、药物性肝病、全胃肠外营养、肝豆状核变性、自身免疫性肝病等可导致脂肪肝的特定疾病； ③B超检查确诊脂肪肝； ④ALT、AST、γ-GT升高 ......
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