二甲双胍治疗非酒精性脂肪肝疗效观察.docVIP

二甲双胍治疗非酒精性脂肪肝疗效观察 　　[摘要] 目的 观察二甲双胍治疗非酒精性脂肪肝的临床疗效。 方法 46例确诊的非酒精性脂肪肝患者，饮食控制的基础上，随机分为两组，治疗组23例给予二甲双胍片治疗，对照组23例给予维生素C片治疗，疗程为6个月，比较治疗前后患者的血清转氨酶水平、血脂水平、空腹血糖（FPG）、空腹血清胰岛素（FInS）、胰岛素抵抗指数（HOMA-IR）及肝脏彩色多普勒B超影像学改变。同时观察治疗过程中出现的不良反应。 结果 治疗组患者的血清丙氨酸氨基转移酶（ALT）、天门冬氨酸氨基转移酶（AST）、血清总胆固醇（TC）、三酰甘油（TG）及低密度脂蛋白（LDL-C）水平明显下降（P＜0.05，P＜0.01），且胰岛素抵抗指数（HOMA-IR）明显改善（P＜0.01），肝脏B超影像学显示有所改善；对照组所有指标无明显改善（P＞0.05）。两组患者均未出现明显不良反应。 结论 二甲双胍可以明显改善胰岛素抵抗，对非酒精性脂肪肝有一定的治疗作用。 　　[关键词] 二甲双胍；维生素C；非酒精性脂肪肝；胰岛素抵抗 　　[中图分类号] R657.3 [文献标识码] B [文章编号] 1673-9701（2012）02-0050-02 　　 　　Clinical effect of metformin on patients with non-alcoholic fatty liver disease 　　NI Liying 　　Department of Emergency, Peoples Hospital of Shengzhou County in Zhejiang Province, Shengzhou 312400, China 　　[Abstract] Objective To assess the therapeutic effect of metformin on patients with non-alcoholic fatty liver disease. Methods Forty six patients with non-alcoholic fatty liver disease were randomly divided into two groups and the patients in treatment group were treated with metformin (n=23), while in control group treated with vitamin C(n=23) for consecutive 6 months, and serum transaminase level (ALT, AST), triglyceride (TG), cholesterol (TC, LDL-C and HDL-C), fasting plasma glucose (FPG), fasting insulin (FInS), insulin resistance index(IRI)and B-ultrasonic of liver were detected pre- and post-treatment,respectively. Side-effect was also observed during the experiment. Results After taking metformin,the levels of serum ALT, AST, TG, TC, LDL-C and HOMA-IR decreased significantly(P＜0.05), B-ultrasonic examination of liver showed the improvement of fatty liver; while the change wasnt obvious in control group (P＞0.05). and no severe side-effects occurred during the experiment. Conclusion Metformin can reduce the insulin resistance, it is an effective remedy for patients with non-alcoholic fatty liver disease. 　　[Key words] Metformin; Vitamin C; Non-alcoholic fatty liver disease; Insulin resistance 　　 　　随着人们生活水平的提高、生活方式的改变，非酒精性脂肪肝(non