短期二甲双胍治疗肥胖儿童非酒精性脂肪性肝病的疗效分析

发布时间：2018-05-27 19:27

本文选题：二甲双胍 + 非酒精性脂肪性肝病/NAFLD　；参考：《中山大学学报(医学科学版)》2017年03期

【摘要】：【目的】观察二甲双胍对于肥胖儿童非酒精性脂肪性肝病(NAFLD)的治疗效果。【方法】回顾性分析2013年7月10日至2016年8月23日中山大学附属第一医院儿科内分泌门诊诊断为NAFLD,伴ALT、AST升高,单纯使用二甲双胍进行治疗的患儿,共10例。比较二甲双胍治疗前后患儿的肝酶学、肝脏彩超表现、血脂、血糖、胰岛素、稳态模型胰岛素抵抗指数(HOMA-IR),BMI及腰围身高比(WHtR)的变化。【结果】脂肪性肝炎(NASH)患儿10例,其中男孩5例,女孩5例。二甲双胍短期治疗后血ALT、AST、HOMA-IR、空腹胰岛素及WHtR均较治疗前降低(P0.05),其中ALT、AST、HOMAIR降低显著(P0.01),下降率为100%(10/10),并随疗程延长呈逐渐下降趋势,而BMI、TG、血糖在治疗前后无统计学差异(P0.05)。其中3例有复查肝脏彩超的患儿均显示脂肪肝程度有所改善。【结论】二甲双胍治疗短期内即可有效的改善NASH患儿肝酶学的异常和胰岛素敏感性,而短期内对于血脂和BMI无明显改善。
[Abstract]:[objective] to observe the therapeutic effect of metformin on nonalcoholic fatty liver disease (NAFLDD) in obese children. [methods] retrospective analysis was made from July 10, 2013 to August 23, 2016 in the pediatric endocrine door of the first affiliated Hospital of Sun Yat-sen University. NAFLD was diagnosed with elevated alt. 10 cases were treated with metformin alone. The changes of liver enzymology, liver color Doppler imaging, blood lipids, blood glucose, insulin, homeostasis model insulin resistance index (HOMA-IR) and waist height ratio (WHTR) were compared before and after metformin treatment. [results] there were 10 cases of fatty hepatitis with NASH. There were 5 boys and 5 girls. After short term treatment with metformin, the levels of alt ASTT HOMA-IR, fasting insulin and WHtR were significantly lower than those before treatment (P 0.05), and the decrease rate was 100 ~ 10 / 10 ~ 10 / 10 ~ (-1), and there was no significant difference in blood glucose between before and after treatment (P 0.05). Among them, 3 cases with reexamination of liver color Doppler ultrasound showed that the degree of fatty liver was improved. [conclusion] metformin treatment can effectively improve the liver enzyme abnormality and insulin sensitivity in NASH children in a short period of time. There was no significant improvement in blood lipid and BMI in the short term.
【作者单位】：中山大学附属第一医院儿科;
【基金】：广东省科技计划项目(2007B031500006)
【分类号】：R725.7

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