复合乳酸菌治疗非酒精性脂肪性肝病的效果分析

贺星; 王晓辉; 闫志辉; 李超; 弓三东; 崔立红

doi:10.3969/j.issn.2095-5227.2015.10.007

摘要: 目的探讨复合乳酸菌在治疗非酒精性脂肪性肝病中的效果。方法选择2011年6月- 2014年6月于我院就诊的114例非酒精性脂肪性肝病患者为研究对象，随机分为观察组和对照组各57例。观察组接受复合乳酸菌(0.66 g，3/d，16 weeks)联合生活方式干预治疗，对照组仅接受生活方式干预治疗。16周后，比较两组治疗前后肝功能、血脂水平、炎性细胞因子、体质量指数(body mass index，BMI)、胰岛素抵抗(insulin resistance，IR)指数及治疗效果的差异。结果两组治疗前后血清丙氨酸氨基转移酶(alanine aminotransferase，ALT)(U/L)(对照组86.65±28.34 vs 76.19±23.32；观察组85.41±27.59 vs 66.81±26.76)、天冬氨酸氨基转移酶(aspartate aminotransferase，AST)(U/L)(对照组69.73±24.74 vs 60.49±18.15；观察组68.35±26.62 vs 53.12±19.59)、三酰甘油(triglycerides，TG)(mmol/L)(对照组3.59±0.48 vs 3.35±0.43；观察组3.75±0.46 vs 2.83±0.37)、总胆固醇(total cholesterol，TC)(mmol/L)(对照组6.17±0.76 vs 5.83±0.72；观察组6.15±0.81 vs 5.54±0.69)、白细胞介素-6(interleukins-6，IL-6)(pg/ml)(对照组135.64±12.14 vs 129.94±11.36；观察组133.67±13.25 vs 97.86±11.82)、肿瘤坏死因子-α(tumor necrosis factor-α，TNF-α)(pg/ml)(对照组10.69±3.23 vs 8.84±3.17；观察组10.68±3.43 vs 7.29±1.75)、体质量指数(kg/m²)(对照组31.34±2.35 vs 30.02±2.31；观察组31.58±2.36 vs 28.12±2.23)、胰岛素抵抗指数(对照组2.77±0.38 vs 2.62±0.34；观察组2.79±0.39 vs 2.46±0.33)均明显降低(P< 0.05)，但观察组(ALT：66.81±26.76；AST：53.12±19.59；TG：2.83±0.37；TC：5.54±0.69；IL-6：97.86±11.82；TNF-α：7.29±1.75；BMI：28.12±2.23；IR：2.46±0.33)较对照组(ALT：76.19±23.32；AST：60.49±18.15；TG：3.35±0.43；TC：5.83±0.72；IL-6：129.94±11.36；TNF-α：8.84±3.17；BMI：30.02±2.31；IR：2.62±0.34)下降更为明显(P< 0.05)，观察组治疗效果(73.68% vs 36.84%)明显优于对照组(P< 0.05)。结论复合乳酸菌能够改善非酒精性脂肪性肝病患者血脂水平、肝功能、BMI及胰岛素抵抗指数，疗效显著。

Abstract: Objective To investigate the efficacy of composite lactobacillus in patients with non-alcoholic fatty liver disease. Methods From June 2011 to June 2014, 114 patients with non-alcoholic fatty liver disease in our hospital were chosen as research objects. All patients were randomly divided into observation group (n=57) and control group (n=57). Patients in observation group received composite lactobacillus (0.66 g, 3/d, 16 weeks) combined with life-style intervention, while patients in control group only received life-style intervention. After 16 weeks of treatment, the differences of liver function, serum lipid levels, inflammatory cytokines, body mass index, insulin resistance index and treatment effect before and after treatment in observation group and control group were compared. Results After treatment, the serum alanine aminotransferase (ALT, control group 86.65±28.34 vs 76.19±23.32; observation group 85.41±27.59 vs 66.81±26.76), aspartate aminotransferase (AST, control group 69.73±24.74 vs 60.49±18.15; observation group 68.35±26.62 vs 53.12±19.59), triglycerides (TG, control group 3.59±0.48 vs 3.35±0.43; observation group 3.75±0.46 vs 2.83±0.37), total cholesterol (TC, control group 6.17±0.76 vs 5.83±0.52; observation group 6.15±0.81 vs 5.54±0.69), interleukins-6 (IL-6, control group 135.64±12.14 vs 129.94±11.36; observation group 133.67±13.25 vs 97.86±11.82), tumor necrosis factor-α (TNF-α, control group 10.69±3.23 vs 8.84±3.17; observation group 10.68±3.43 vs 7.29±1.75), body mass index (BMI, control group 31.34±2.35 vs 30.02±2.31; observation group 31.58±2.36 vs 28.12±2.23), insulin resistance index (IR, control group 2.77±0.38 vs 2.62±0.34; observation group 2.79±0.39 vs 2.46±0.33) in both observation group and control group were lower than before treatment (P< 0.05), and the observation group (ALT: 66.81±26.76; AST: 53.12±19.59; TG: 2.83±0.37; TC: 5.54±0.69; IL-6: 97.86±11.82; TNF-α: 7.29±1.75; BMI: 28.12±2.23; IR: 2.46±0.33) decreased more significantly than control group (ALT: 76.19±23.32; AST: 60.49±18.15; TG: 3.35±0.43; TC: 5.83±0.72; IL-6: 129.94±11.36; TNF-α: 8.84±3.17; BMI: 30.02±2.31; IR: 2.62±0.34, P< 0.05). The curative effect in observation group were superior to control group (73.68% vs 36.84%), P< 0.05). Conclusion Composite lactobacillus can improve liver function, serum lipid levels, inflammatory cytokines, body mass index, insulin resistance index and its treatment effect is significant.

复合乳酸菌治疗非酒精性脂肪性肝病的效果分析

Efficacy of composite lactobacillus in patients with non-alcoholicfatty liver disease