夜间间歇性低血氧与高血压患者脂肪肝的关系

目的 探讨高血压患者夜间间歇性低血氧与脂肪肝的关系.方法 选择行多导睡眠监测的原发性高血压患者168例,并根据肝脏超声影像学的诊断结果分组,比较两组间临床、实验室资料及多导睡眠监测指标中的睡眠呼吸暂停低通气指数（AHI）、最低血氧饱和度（LSaO2）,分析脂肪肝形成的相关因素.结果 脂肪肝组（101例）较非脂肪肝组（67例）的体重指数、空腹血糖、甘油三酯、丙氨酸氨基转移酶、门冬氨酸氨基转移酶、谷酰转肽酶明显增高（P＜0.05）,但LSaO2水平明显降低[（79.37±9.19）％ vs.（83.12±6.40）％,P＜0.05].Logistic回归分析表明空腹血糖、LSaO2可能是高血压患者脂肪肝的形成的危险因素,OR值分别为3.794（95％ CI：1.678 ～8.578）,3.378（95％ CI：1.464 ～7.796）.结论 高血压患者脂肪肝形成可能与夜间间歇性低血氧有关.

Relationship between nocturnal chronic intermittent hypoxia and fatty liver in hypertensive patients

Objective To investigate the relationship between nocturnal chronic intermittent hypoxia and fatty liver in hypertensive patients.Methods 168 patients with hypertension who underwent both polysomnography and liver ultrasonography were enrolled from July 2004 to March 2006.The main clinical features as well as apneahypnea index（AHI） and the lowest oxygen saturation （LSaO2）,were compared between patients with and without fatty liver,and the potential risk factors of fatty liver were discussed.Results 101 out of 168 cases were diagnosed as fatty liver,in which the body mass index,fasting blood glucose,triglyceride,alanine aminotransferase （ALT）,aspartate amino-transferase（AST）,Gamma-glutamyl transpeptidase（GGT） and mean AHI were significantly higher,while the LSaO2 [（79.37 ＋ 9.19） ％ vs.（83.12 ＋ 6.40） ％,P ＜ 0.05] was much lower compared with patients without fatty liver.The multivariate logistic regression indicated that the fasting blood glucose [OR （95％ CI）：3.794 （1.678-8.578）],LSaO2 [OR （95％ CI）：3.378 （1.464-7.796）] were possible contributing risk factors of fatty liver in patients with hypertension.Conclusion Nocturnal chronic intermittent hypoxia may play a role in the pathogenesis of fatty liver disease in hypertensive patients.