摘要
为了研究阿托伐他汀在治疗非酒精性脂肪性肝病(NAFLD)的作用机制及对于代谢组学的影响,本研究前瞻性地选取了 2022年5月至2023年5月在医院接受治疗的92名NAFLD患者作为研究对象,并按照抽签的方式将他们平均分为两组,分别是对照组和实验组,每组包含46名患者.对照组的患者接受了常规的临床治疗,而实验组的患者则使用阿托伐他汀进行治疗.观察2组治疗前后肝功能、血脂水平及炎症水平指标,利用GC/MS技术在治疗后进行血液代谢组学检测,经多维统计找出差异代谢物,并确定差异代谢通路.结果显示治疗后,实验组患者谷丙转氨酶(ALT)、谷草转氨酶(AST)、直接胆红素(DBiL)、总胆红素(TBiL)水平相较于对照组更低(P＜0.05);治疗后,实验组患者总胆固醇(TC)、甘油三酯(TG)和低密度脂蛋白(LDL-C)水平均低于对照组,高密度脂蛋白(HDL-C)水平则高于对照组(P＜0.05);治疗后,两组炎症水平均得到改善,且观察组白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、超敏C反应蛋白(hs-CRP)水平较于对照组降低更显著(P＜0.05).GC/MS技术检测结果显示,丙氨酸、氨基丁酸、甘露酸、亚油酸、油酸、胆碱、甜菜碱、葡萄糖、甘露糖、氨基糖等代谢产物具有显著差异,所涉及的代谢通路有4条,包括氨基酸代谢、脂类代谢、碱类代谢及糖类代谢通路.阿托伐他汀的应用在治疗NAFLD方面表现出显著效果,不仅能有效地改善患者的肝功能和血脂水平,还能降低炎症反应,GC/MS技术检测结果所涉及的代谢通路包括氨基酸代谢、脂类代谢、碱类代谢及糖类代谢通路.
Abstract
To study the mechanism of atorvastatin in the treatment of nonalcoholic fatty liver disease(NAFLD)and its influence on metabonomics,92 patients with NAFLD who were treated in the authors'hospital from May 2022 to May 2023 were prospectively se-lected for this study and were equally divided into two groups,the control group and the experimental group,each containing 46 pa-tients,according to a lottery.Patients in the control group received conventional clinical treatment,while patients in the experimental group were treated with atorvastatin.Liver function,lipid level and inflammation level indexes were observed before and after treat-ment in the 2 groups,and blood metabolomics testing was performed after treatment using GC/MS technology to find out the differen-tial metabolites and identify the differential metabolic pathways by multidimensional statistics.After treatment,patients in the experi-mental group had lower levels of alanine aminotransferase(ALT),aminotransferase(AST),direct bilirubin(DBiL),and total biliru-bin(TBiL)than those in the control group(P＜0.05);After treatment,patients in the experimental group had lower levels of total cholesterol(TC),triglyceride(TG),and low-density lipoprotein(LDL-C)than those in the control group,and high-density lipopro-tein(HDL-C)levels were higher than those of the control group(P＜0.05);After treatment,the inflammation levels of both groups were improved,and the levels of interleukin-6(IL-6),tumour necrosis factor-α(TNF-α),and ultrasensitive C-reactive protein(hs-CRP)in the experimental group were reduced more significantly than those of the control group(P＜0.05).The results of GC/MS technique showed that alanine,aminobutyric acid,mannuronic acid,linoleic acid,oleic acid,choline,betaine,glucose,mannose,and aminosugar metabolites were significantly different,and there were four metabolic pathways involved,including amino acid metabo-lism,lipid metabolism,alkali metabolism,and sugar metabolism pathway.The application of atorvastatin has shown remarkable results in the treatment of NAFLD,not only effectively improving the liver function and lipid levels of patients,but also reducing the inflam-matory response.The metabolic pathways involved in the results of the GC/MS technique include amino acid metabolism,lipid metabolism,base metabolism,and sugar metabolism pathways.
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