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目的探讨阻塞性睡眠呼吸暂停综合征(OSAHS)患者慢性低氧与非酒精性脂肪肝(NAFLD)的相关性。方法选择OSAHS患者927例,行多导睡眠监测(PSG),按照最低血氧饱和度指数(LSaO2)及呼吸暂停低通气指数(AHI)将患者分为单纯鼾症组63例,轻度低氧血症OSAHS组202例,中度低氧血症OSAHS组332例,重度低氧血症OSAHS组330例;生化分析患者空腹血低密度-脂蛋白-胆固醇(LDL-C)、高密度-脂蛋白-胆固醇(HDL-C)、甘油三酯(TG)、总胆固醇(TC)水平;所有患者均行肝胆胰脾腹部B超检查。结果 1随着缺氧程度加重,OSAHS患者伴NAFLD的检出率升高,重度低氧血症OSAHS伴NAFLD的检出率较单纯鼾症及轻、中度低氧血症的检出率高;2 OSAHS伴NAFLD患者与不伴NAFLD患者BMI、TC、TG、HDL-C、LDL-C及中、重度低氧血症水平相比,差异均有统计学意义(P<0.05);3BMI、TC、TG及中、重度低氧血症是OSAHS伴NAFLD的独立危险因素。结论 BMI、TC、TG、轻中重度低氧血症是OSAHS伴NAFLD的独立危险因素,改善患者长期缺氧状态,减轻体质量,控制甘油三酯水平,可能有效预防NAFLD的发生。
Objective To investigate the relationship between chronic hypoxia and non-alcoholic fatty liver disease (NAFLD) in patients with obstructive sleep apnea syndrome (OSAHS). Methods Nine hundred and seventy-two OSAHS patients underwent polysomnography (PSG). According to the lowest oxygen saturation index (LSaO2) and apnea hypopnea index (AHI), 63 patients were divided into simple snore group, mild hypoxia 202 patients with OSAHS in sepsis, 332 patients with OSAHS in moderate hypoxemia and 330 patients with OSAHS in severe hypoxemia. The levels of fasting blood LDL-C, (HDL-C), triglyceride (TG) and total cholesterol (TC). All patients underwent B ultrasound examination of liver, gallbladder, pancreas and spleen. Results 1 With the aggravation of hypoxia, the detection rate of NAFLD increased in patients with OSAHS. The detection rate of severe hypoxemia OSAHS with NAFLD was higher than that of simple snoring and mild to moderate hypoxemia ; 2 There were significant differences in BMI, TC, TG, HDL-C, LDL-C and moderate and severe hypoxemia between OSAHS patients with NAFLD and those without NAFLD (P <0.05) TC, TG and moderate and severe hypoxemia are independent risk factors for OSAHS with NAFLD. Conclusion BMI, TC, TG, mild to moderate hypoxemia are independent risk factors of OSAHS with NAFLD. To improve long-term hypoxia, reduce body weight and control triglyceride levels may be effective in preventing NAFLD.