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《慢性病学杂志》[ISSN:1674-8166/CN:11-5900/R]

卷:

期数:

2015年6期

页码:

626-629

栏目:

论　著

出版日期:

2015-12-27

文章信息/Info

Title:

Evaluation analysis of FibroScan-CAP on Silibinin and exercise therapies for treament of nonalcoholic fatty hepatitis

作者:

牛卫理¹;  孙亮²;  杨小军¹;  纪明平¹;  崔小玲¹

1.河南省鹤壁市传染病医院肝炎科，河南鹤壁458000；2.郑州大学公共卫生学院社会医学教研室，郑州450001

Author(s):

NIU Wei-li*;  SUN Liang;  YANG Xiao-jun;  JI Ming-ping;  CUI Xiao-ling

* Hepatitis Dept of Hebi Infectious Disease Hospital, Hebi, Henan 458000, China Corresponding author: NIU Wei-li, E-mail: niuweili1021@126.com

关键词:

瞬时弹性成像; 受控衰减参数; 水飞蓟宾; 运动疗法; 非酒精性脂肪性肝炎

Keywords:

FibroScan;  Controlled attenuation parameter;  Exercise therapies;  Silymarin;  Nonalcoholic fatty hepatitis

分类号:

R575.1

DOI:

-

摘要:

目的应用瞬时弹性成像(FibroScan)技术受控衰减参数（CAP） 观察水飞蓟宾联合运动疗法治疗非酒 精性脂肪性肝炎（NASH） 的临床疗效。方法2013 年3 月—2014 年9 月鹤壁市传染病医院门诊及住院的 NASH 患者65 例， 均在积极治疗原发病的基础上给以飞蓟宾胶囊， 开始每次2 粒（70 mg）， 3 次/d 口 服，4 周为1 疗程，12 周为总疗程。并同时进行运动疗法：由2 名接受专业培训的临床医师负责评估，并 且个体化定制个人运动计划。每2~4 周检测并记录患者临床症状、体质量指数（BMI）、腰围/臀围 （ACR）、肝功能、血脂指标的变化以及CAP。结果联合治疗后乏力、纳差、腹胀、肝区隐痛等比例与治 疗前比较差异均有统计学意义（P<0.01）；治疗后TG、TC、ALT、AST 水平及BMI、ACR 等较治疗前 改善明显，差异有统计学意义（P<0.05 或P<0.01）；治疗后第8、12 周CAP 较治疗前差异有统计学意义 （P<0.05、P<0.01）。结论飞蓟宾联合运动疗法可以改善NASH 患者的临床症状、血清生化指标、BMI 及ACR。应用FibroScan-CAP 动态检测肝脂肪变是一种无创、定量、快速、可靠的评估脂肪性肝病的新 方法。

Abstract:

Objective To observe the effect of silibinin combined with exercise in treating non-alcoholic fatty hepatitis (NASH),using transient elastography (FibroScan) of the controlled attenuation parameter (CAP). Methods A total of 65 patients of NASH in Hebi Infectious Disease Hospital from March 2013 to September 2014, on top of the original treatment plan, were all administered with oral Sillibinin Capsule, 2 capsules (70 mg) each time, 3 times daily, 4 weeks for one course of treatment, 12 weeks for the total of 3 courses. At the same time, the patients received exercise therapies including assessment and design of personalized sports program by two specialist physicians with professional training. The clinical symptoms, body mass index (BMI), waist/hip (ACR), liver function, changes of serum lipids and CAP of NASH patients were detected and recorded every 2- 4 weeks. Results After the combination therapy, the differences between the treated and untreated patients for the proportion of fatigue, anorexia, abdominal distension, liver area pain were statistically significant (P<0.01). after the treatment, the levels of TC, ALT, AST, BMI, TG and ACR were significantly improved, compared with no treatment (P<0.05 or 0.01). CAP at the 8th and 12th week post-treatment was statistically significant (P<0.05, P<0.01). Conclusions Silibinin and exercise therapies can improve clinical symptoms,serum biochemical parameters, BMI and ACR of NASH patients. Dynamic detection of hepatic steatosis by FibroScan-CAP is a novel method for the evaluation of NASH with the advantage of being noninvasive, quantitative, rapid and reliable.

参考文献/References:

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备注/Memo

备注/Memo:

基金项目：河南省基础与前沿技术研究计划项目（132300410271） 作者简介：牛卫理，大学本科，副主任医师，研究方向：慢性肝病的诊治 通信作者：牛卫理，E-mail: niuweili1021@126.com

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更新日期/Last Update: 2015-12-27