睡眠呼吸暂停低通气综合征与NAFLD关系的Meta分析  

Meta-analysis on the relationship between sleep apnea-hypopnea syndrome and liver injury

作　　者：王琳[1] 田建立[1] 李岱[1] 冯淑芝[1] 任美书[1] 

机构地区：[1]天津医科大学总医院保健医疗部,天津市老年病学研究所,300052

出　　处：《天津医药》2015年第9期1069-1073,共5页Tianjin Medical Journal

基　　金：天津市自然科学基金资助项目(11JCYBJC28300);天津市卫生局科技基金(2014KZ119);卫计委国家临床重点专科建设项目

摘　　要：目的 评价睡眠呼吸暂停低通气综合征（SAHS）与非酒精性脂肪性肝病（NAFLD）的相关性。方法 检索Web of science、EMbase、Pubmed、Springer Link、EBSCO数据库、中国学术期刊网全文、重庆维普中文科技期刊全文、万方科技期刊全文数据库中发表的有关SAHS与NAFLD关系的病例-对照研究,由2名评价员独立对纳入的研究进行质量评价和数据提取,利用Rev Man 5.1和Stata 12.0统计软件进行Meta分析。结果 共纳入符合标准的文献11篇。Meta分析结果显示SAHS患者与非SAHS患者相比存在NAFLD的危险增加（RR=2.82,95%CI：2.03~3.92,P〈0.01）;SAHS患者血清丙氨酸转氨酶（ALT）升高（SMD=0.53,95%CI：0.02~1.05,P〈0.05）;在SAHS患者中,重度NAFLD患者呼吸暂停低通气指数（AHI）较轻度NAFLD者升高（SMD=1.42,95%CI：0.12~2.72,P〈0.05）。结论 SAHS患者患NAFLD的风险增加,NAFLD的严重程度随间歇低氧严重程度的增加而增加。Objective To provide an comprehensive evaluation of the correlation between sleep apnea hypopnea syndrome （SAHS） and nonalcoholic fatty liver disease （NAFLD）. Methods The various case-control studies on the relationship between SAHS and NAFLD were retrieved from all kinds of large-scale databases at home and abroad （including Web of science, EMbase, Pubmed, Springer Link, EBSCO Databases, CNKI, CQVIP, Wanfang Data）. The quality evaluation of included studies was made by two independent researchers. RevMan 5.1 and stata 12.0 software were used for meta-analysis. Results A total of 11 qualified documents were included in this study. Meta analysis showed that the relative risk of NAFLD was increased in SAHS patients than non-SAHS patients （RR=2.82, 95%CI：2.03-3.92, P〈0.01）. The serum alanine aminotransferase （ALT） increased in SAHS patients （SMD=0.53, 95% CI：0.02-1.05, P 〈 0.05）. Compared with non-SAHS patients, the apnea-hypopnea index （AHI） was significantly higher in SAHS patients combined with severe NAFLD than those combined with mild NAFLD （SMD=1.42, 95%CI：0.12-2.72, P 〈 0.05）. Conclusion The risk of NAFLD increases in SAHS patients. The severity of NAFLD is relatively higher with the severity of intermittent hypoxia.

关 键 词：睡眠呼吸暂停综合征 脂肪肝 转氨酶类 META分析 非酒精性脂肪性肝病 丙氨酸转氨酶 天冬氨酸转氨酶 睡眠呼吸暂停低通气综合征 

分 类 号：R563[医药卫生—呼吸系统]