阻塞性睡眠呼吸暂停低通气综合征肝酶升高的危险因素分析  

Risk factors of elevated liver enzymes in obstructive sleep apnea hypopnea syndrome

作　　者：秦兵俊 邹亚宁 宋诗文 李雨凝 蒋军广[1] QIN Bingjun;ZOU Yaning;SONG Shiwen;LI Yuning;JIANG Junguang(Department of Geriatric Respiratory and Sleep Medicine,The First Affiliated Hospital of Zhengzhou University,Henan Provincial Respiratory Diseases Institute,Zhengzhou,Henan 450052,China)

机构地区：[1]郑州大学第一附属医院/河南省呼吸疾病研究所老年呼吸睡眠科,河南郑州450052

出　　处：《临床肺科杂志》2025年第5期717-721,共5页Journal of Clinical Pulmonary Medicine

基　　金：国家卫生和计划生育委员会临床重点专科建设项目(国卫办医函〔2013〕544号)。

摘　　要：目的探讨阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea hypopnea syndrome,OSAHS)患者肝酶升高的相关危险因素。方法选取郑州大学第一附属医院接受多导睡眠监测(polysomnography,PSG)的患者196例,其中OSAHS患者142例(轻-中度OSAHS 54例,重度OSAHS 88例),非OSAHS患者54例。对所有患者进行体格检查、肝功能及血脂指标检测,应用SPSS 26.0软件进行统计学分析。结果三组间谷丙转氨酶(alanine aminotransferase,ALT)、谷草转氨酶(aspartate aminotransferase,AST)、谷氨酰转肽酶(gamma-glutamyl transferase,GGT)、肝酶升高比例、异常ALT升高比例、异常AST升高比例、异常GGT升高比例均有统计学差异(P<0.05);在OSAHS组中,ALT、AST及GGT与氧减指数(oxygen desaturation index,ODI)、身体质量指数(body mass index,BMI)、总呼吸暂停时间(total apnea time,TAT)、呼吸暂停低通气指数(apnea-hypopnea index,AHI)、血氧饱和度低于90%的时间(cumulative time spent with oxygen saturation below 90%,CT90%)呈正相关,与最低血氧饱和度(lowest oxygen saturation,LSaO 2)呈负相关(P<0.05);以肝酶是否升高为结局变量,建立二分类Logistic回归模型,结果示CT90%、ODI进入模型,OR值(95%CI)分别是1.075(1.026~1.126)、1.093(1.063~1.124)。结论OSAHS与肝酶升高密切相关,CT90%、ODI是导致OSAHS患者肝酶升高的独立危险因素。Objective To investigate the risk factors associated with elevated liver enzymes in patients suffering from obstructive sleep apnea hypopnea syndrome(OSAHS).Methods A total of 196 patients who underwent polysomnography(PSG)at the First Affiliated Hospital of Zhengzhou University were selected for the study.Among them,142 were diagnosed with OSAHS(54 with mild to moderate OSAHS and 88 with severe OSAHS),and 54 did not have OSAHS.All patients received physical examinations and tests for liver function and blood lipid levels.Data were analyzed using SPSS 26.0 software.Results Significant differences were found among the three groups in terms of alanine aminotransferase(ALT),aspartate aminotransferase(AST),gamma-glutamyl transferase(GGT),the proportion of elevated liver enzymes,and the proportions of elevated ALT,AST,and GGT(P<0.05).In the OSAHS group,ALT,AST,and GGT levels were positively correlated with oxygen desaturation index(ODI)、body mass index(BMI)、total apnea time(TAT)、apnea-hypopnea index(AHI)、cumulative time spent with oxygen saturation below 90%(CT90%),but negatively correlated with lowest oxygen saturation(LSaO 2)(P<0.05).A binary logistic regression model,using elevated liver enzymes as the outcome variable,identified CT90%and ODI as significant factors,with odds ratios(95%CI)of 1.075(1.026–1.126)and 1.093(1.063–1.124),respectively.Conclusion There is a close association between OSAHS and elevated liver enzymes.CT90%and ODI are independent risk factors for elevated liver enzymes in patients with OSAHS.

关 键 词：阻塞性睡眠呼吸暂停低通气综合征 转氨酶类 慢性间歇性缺氧 肝损伤 

分 类 号：R563.9[医药卫生—呼吸系统]