那格列奈治疗伴有糖耐量异常的非酒精性脂肪性肝病的临床研究(1)
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[摘要] 目的 探讨那格列奈对伴有糖耐量异常(IGT)的非酒精性脂肪性肝病(NAFLD)的疗效。方法 选择伴有IGT的NAFLD患者60例，随机分为那格列奈治疗组 (n=30)和无药物治疗对照组(n=30)， 治疗组每餐前服药(270mg /d)每天三次，共20周，记录治疗前后患者的临床症状，血清丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、谷氨酰转肽酶(GGT)、甘油三酯(TG)、总胆固醇(TC)、 空腹血浆葡萄糖(FPG)、胰岛素(FPI)及糖化血红蛋白(HbA1c)水平，及肝脏的超声表现。结果 那格列奈治疗组与对照组相比各项生化指标明显改善(P<0.05)，肝脏超声检查改善率亦高于对照组(60% vs 16.7% )。结论 那格列奈能有效改善伴有IGT的NAFLD患者的胰岛素抵抗、肝功能、血脂和肝脏的超声表现，可以作为和并IGT的NAFLD的治疗选择。
[关键词] 非酒精性脂肪性肝病； 那格列奈
[中图分类号] R975+.5[文献标识码] A[文章编号] 1005-0515(2011)-01-014-02
Therapeutic effects of nateglinide on the non-alcoholic steatohepatitis with impaired glucose tolerance
Wu Qian
(Qingdao Eighth People's Hospital Department of gastroenterology 266071)
[Abstract]Objective To investigate the effects of nateglinide in treatment of nonalcoholic fatty liver disease(NAFLD) with impaired glucose tolerance (IGT).Methods sixty patients were randomized into two groups.30 cases (nateglinide group) were given nateglinide (270mg /d)three times a day，and 30 cases(control group)were given nothing.The course of the treatment was 20 weeks.Before and after the treatment，clinical symptoms，levels of serum alanine aminotransferase(ALT)，aspartate aminotransferase(AST)，gamma glutamyl transferase(GGT)，triglyceride(TG),total cholesterol(TC) , fasting plasma glucose(FPG),fasting plasma insulin(FPI) ,HbA1c and hepatic ultrasonography were recorded respectively.Results compared with control group nateglinide can amerliorate the biochemical indicators of the non-alcoholic steatohepatitis with impaired glucose tolerance, and the hepatic ultrasonography examination shows that the rate of improvement in nateglinide group was significantly higher than that of in the control group(60% vs 16.7% ，P<0.05).Conclusion nateglinide can effectively improve liver function and serum triglyceride and cholesterol，and ameliorate the imagination of hepatic ultrasonography of patients with NAFLD. It is a choice for the patients NAFLD with IGT.
[Keywords] non-alcoholic steatohepatitis； nateglinide
近年来随着人们生活水平的提高和生活方式的改变非酒精性脂肪性肝病(NAFLD)在全球范围内患病率迅速增高。患者常伴有超重或肥胖，糖耐量异常或2型糖尿病以及血脂紊乱等易患因素。包括单纯性脂肪肝(NAFL)，伴有肝细胞损伤和炎症反应的非酒精性脂肪性肝炎(NASH)，最终可发展为肝纤维化、肝硬化乃至肝细胞癌[1]。探讨对NAFLD具有治疗作用的药物 ......
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