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目的探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)中非酒精性脂肪肝(NAFLD)患者的病程与肝功能各参数变化的关系。方法选择2012-2015年在首都医科大学大兴教学医院确诊的OSAHS患者96例为观察组,并根据病史长短分为A组(<5年)20例、B组(5~10年)36例、C组(>10年)40例,另选同期50例体检正常者为对照组。观察各组NAFLD的患病率,BMI、AHI、LSaO_2及肝功能指标ALT、AST、GGT、TBIL、TBA变化。结果(1)对照组、A组、B组、C组的NAFLD患病率依次升高,差异均有统计学意义(P<0.05)。(2)对照组BMI低于A组,低于B、C两组;对照组、A组、B组、C组AHI依次升高;对照组LSaO_2高于A、B两组,高于C组,差异均有统计学意义(P<0.05)。(3)对照组ALT低于A组,低于B、C两组;C组AST高于对照组、A组;C组TBA较对照组、A组、B组均明显升高,差异有统计学意义(P<0.05)。各组间GGT、TBIL比较差异无统计学意义(P>0.05)。结论(1)OSAHS患者NAFLD患病率明显升高,且随着病程的延长其患病率也逐渐升高。(2)随着OSAHS病程越长,AHL、BMI升高,LSaO_2降低。(3)OSAHS可引起ALT增高,且随OSAHS发病时间的延长而更加明显,血清AST、TBA升高在>10年组更明显。
Objective To investigate the relationship between the course of disease and the changes of liver function parameters in non-alcoholic fatty liver disease (NAFLD) patients with obstructive sleep apnea-hypopnea syndrome (OSAHS). Methods Ninety-six patients with OSAHS diagnosed at Capital Medical University Daxing Teaching Hospital from 2012 to 2015 were selected as observation group and divided into two groups according to the length of their history: group A (n = 20), group B (n = 5 to 10) C group (> 10 years) 40 cases, another 50 cases of the same period normal physical examination as the control group. The prevalences of NAFLD, BMI, AHI, LSaO_2, ALT, AST, GGT, TBIL and TBA in each group were observed. Results (1) The prevalence of NAFLD in control group, A group, B group and C group increased successively, the differences were statistically significant (P <0.05). (2) The BMI of the control group was lower than that of the A group and lower than that of the B and C groups. The AHI of the control group, A group, B group and C group increased in turn, while the LSaO_2 in the control group was higher than those in A and B groups , The differences were statistically significant (P <0.05). (3) The ALT of the control group was lower than that of the A group and lower than that of the B and C groups; the AST of the C group was higher than that of the control group, and the TBA of C group was significantly higher than that of the control group, A group and B group Significance (P <0.05). There was no significant difference in GGT and TBIL between groups (P> 0.05). Conclusions (1) The prevalence of NAFLD in patients with OSAHS was significantly higher, and the prevalence of NAFLD gradually increased with the duration of the disease. (2) With the longer duration of OSAHS, AHL, BMI increased, LSaO_2 decreased. (3) OSAHS can cause increased ALT, and with the onset of OSAHS time more obvious, serum AST, TBA increased more than 10 years group.