Hyperlipidemia complicated by fatty liver Drug guidance:
The main causes of fatty liver are alcohol consumption, obesity, type 2 diabetes mellitus and hyperlipidemia. In addition, some drugs and poisons, acute weight loss, total parenteral nutrition and chronic hepatitis can also lead to fatty liver.
First, in principle, patients with fatty liver without hyperlipidemia do not need lipid-lowering drugs. Those with hyperlipidemia should use lipid-lowering drugs on the basis of comprehensive treatment, but the liver function should be appropriately reduced and monitored, and liver protective drugs should be used when necessary. Consider using lipid-lowering drugs in the following cases: those with obesity, diabetic fatty liver accompanied by hyperlipidemia and coronary heart disease; Obesity, diabetic fatty liver with hyperlipidemia, after dietary control, increased exercise and treatment of the primary disease for 3 months, the blood lipids continued to be abnormal; Fatty liver caused by primary hyperlipidemia.
Second, the rational choice of lipid-lowering drugs. Phenoxyaromatic acids can be used as lipid-lowering drugs for fatty liver with significantly increased plasma triacylglycerol. For example, bezafibrate 0.2g, 3 times / day, gefitrazil 0.6g, 2 times / day, fenofibrate 0.1g, 3 times / day. Statins (HMG CoA reductase inhibitors) can be used for fatty liver with significantly increased plasma cholesterol. Lipid lowering drugs have more or less some adverse reactions. For patients who need to use these drugs for a long time, especially those who need combination drugs, they need to closely monitor liver and kidney functions and blood routine. Some serious cases can appear rhabdomyolysis, Melania, renal failure, and even lead to death or lifelong disability. If alanine aminotransferase (ALT) >3uln in the application of lipid-lowering drugs, it should be considered to stop the drug.
