上海交通大学学报（医学版）

上海交通大学学报（医学版）

• 论著（临床研究） • 上一篇    下一篇

阻塞性睡眠呼吸暂停低通气综合征对非酒精性脂肪性肝病的影响

孙雯雯，阮玉凤，连鹏，应晨，胡家安，徐志红，孙璟   

  1. 上海交通大学  医学院附属瑞金医院老年病科， 上海 200025
  • 出版日期:2016-05-28 发布日期:2016-05-26
  • 通讯作者: 孙璟, 电子信箱: sj10535@rjh.com.cn; 徐志红, 电子信箱: zhihxu@163.com。
  • 作者简介:孙雯雯（1988—）， 女， 住院医师， 硕士生; 电子信箱: 969224983@qq.com。
  • 基金资助:

    上海市卫计委重要薄弱学科建设项目（2015ZB0503）

Effects of obstructive sleep apnoea syndrome on non-alcoholic fatty liver disease

SUN Wen-wen, RUAN Yu-feng， LIAN Peng, YING Chen, HU Jia-an, XU Zhi-hong, SUN Jing   

  1. Department of Gerontology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
  • Online:2016-05-28 Published:2016-05-26
  • Supported by:

    Weak Disciplines Construction Project Fundingby Healthand Family Planning Commission of Shanghai, 2015ZB0503

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摘要：

目的 探讨阻塞性睡眠呼吸暂停低通气综合征（OSAS）对非酒精性脂肪性肝病（NAFLD）的影响。方法 该实验为观察性研究。在2009年1月—2015年12月因打鼾在上海交通大学医学院附属瑞金医院老年病科就诊的患者中，选取诊断为OSAS的159位患者作为病例组（OSAS组），159位非OSAS患者作为对照组，应用Mann-Whitney U非参数检验分析2组患者间是否匹配，比较2组NAFLD的发生率。将OSAS组分别依据睡眠呼吸暂停低通气指数(AHI)和最低血氧饱和度(L-SaO2)分为3组（轻、中、重），运用卡方R×C列联表对OSAS各亚组患者NAFLD的发生情况进行统计学分析。结果 与对照组比较，OSAS组AHI较高（P=0.000），L-SaO2较低（P=0.000），血氧饱和度<90%的时间(TSaO2<90%)较长（P=0.000），NAFLD的发生率较高(P=0.016）。依据AHI分层和L-SaO2分层，OSAS各亚组间NAFLD发生率的差异均有统计学意义（χ2=6.455，P=0.040；χ2=6.097, P=0.047）。结论 OSAS能够增加NAFLD的发生，而NAFLD的发生亦随着OSAS患者缺氧程度的加重而增加。

关键词: 阻塞性睡眠呼吸暂停低通气综合征, 非酒精性脂肪性肝病, 睡眠呼吸暂停低通气指数, 最低血氧饱和度

Abstract:

Objective To explore the effects of obstructive sleep apnoea syndrome (OSAS) on non-alcoholic fatty liver disease (NAFLD). Methods This study is an observational study, which recruited 159 patients who have been diagnosed with OSAS (the OSAS group) among patients visiting the Department of Gerontology at Ruijin Hospital affiliated to Shanghai Jiao Tong University School of Medicine due to snore between January 2009 and December 2015 and 159 non-OSAS patients (the control group). Mann-Whitney U non-parametric test was used to analyze whether the OSAS group matched with the control group and the incidence of NAFLD in two groups was compared. The OSAS group was divided into mild, moderate, and severe subgroups according to the apnea hyponea index (AHI) and lowest oxyhemoglobin saturation (L-SaO2). Chi-square R×C contingency table was employed to statistically analyze the prevalence of NAFLD in OSAS subgroups. Results The OSAS group had a higher AHI (P=0.000), a lower level of L-SaO2 (P=0.000), a longer duration of hemoglobin desaturation (TSaO2<90%)(P=0.000), and a higher incidence of NAFLD (P=0.016) as compared with the control group. The difference in the NAFLD incidence in OSAS subgroups stratified by AHI and L-SaO2 was statistically significant AHI (χ2=6.455, P=0.040; χ2=6.097, P=0.047). Conclusion OSAS can increase the incidence of NAFLD and the incidence of NAFLD increases with the degree of hypoxia in patients with OSAS.

Key words: obstructive sleep apnoea syndrome；non-alcoholic fatty liver disease, apnea hyponea index, lowest oxyhemoglobin saturation