二甲双胍对糖耐量异常非酒精性脂肪性肝病患者 IL-6、TNF-α的影响

摘要

Objective To evaluate the efficacy of metformin on the level of interleukin-6 and tumor necrosis factor-αof impaired glucose tolerance patients with non-alcoholic fatty liver disease .Method 160 impaired glucose tolerance patients with non-alcoholic fatty liver disease were firstly divided into an experimental group (n=90) and a control group(n=70). On the basis of strict diet control and physical exercise , the experimental group was given metformin 1500 mg per day for a period of 24 weeks.The control group was treated with polyene phosphatidylcholine capsules 456mg per day also for a period of 24 weeks.Results After 24 weeks of treatment, the level of body mass index (BMI), anine aminotrans-ferase (ALT), fasting blood glucose (FPG), insulin, homeostasis model assessment-insulin resistance (HOMA IR) of the experimental group decreased more significantly than those of the control group (P0.05).Conclusion The metformin treatment could improve the glucose metabolism indexes and insulin resistance of impaired glucose tolerance patients with non-alcoholic fatty liver disease , reduce liver enzyme and inflammatory cytokines , improve liver function , and lessen the degree of inflammation in liver .%目的：观察二甲双胍对糖耐量异常非酒精性脂肪性肝病（ nonalcoholic fatty liver disease ， NAFLD）患者IL-6、TNF-α的影响。方法将160例糖耐量异常NAFLD患者随机分为观察组（ n＝90）和对照组（ n＝70）。在严格控制饮食和运动的基础上，观察组加用二甲双胍1500 mg／d，对照组加用多烯磷脂酰胆碱胶囊456 mg／d，均治疗24周。结果治疗24周后，与对照组比较，观察疗组患者BMI、ALT、FPG、insulin、HOMA-IR、hs-CRP、TNF-α和IL-6水平均显著降低（P＜0．05）；两组间AST水平差异无统计学意义（P＞0．05）。结论二甲双胍能改善糖耐量异常NAFLD患者糖代谢指标和胰岛素抵抗，降低肝酶和炎症细胞因子水平。