作　　者： ; ; ;

机构地区： 暨南大学附属第一医院

出　　处： 《暨南大学学报（自然科学与医学版）》 2018年第5期454-460,共7页

摘　　要： 目的:探讨在磁共振扫描(MRI)中采用定量非对称回波的最小二乘估算法迭代水脂分离序列(IDEAL-IQ)成像技术评价阻塞性睡眠呼吸暂停低通气综合征(OSAS)患者肝脏脂肪含量及病变程度的可行性.方法:选取106例进行多导睡眠监测患者为研究对象,根据监测结果分为非OSAS组和OSAS组,均进行IDEAL-IQ成像技术检查.将两组患者间一般临床资料、肝脏脂肪含量、实验室检查结果及非酒精性脂肪性肝病(NAFLD)程度分级进行比较,同时行肝脏脂肪含量与血清丙氨酸氨基转移酶(ALT)、门冬氨酸氨基转移酶(AST)的相关性分析.结果:106例患者中非OSAS患者47例,OSAS组患者59例.非OSAS组患者的肝脏脂肪含量为(13. 51±10. 47)%、OSAS组患者的肝脏脂肪含量为(18. 49±7. 90)%,有统计学差异(P <0. 05);两组患者年龄、性别、血清AST、甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)无统计学差异(P> 0. 05); OSAS组体质指数(BMI)、血清ALT、低密度脂蛋白胆固醇(LDL-C)显著高于非OSAS组,均有统计学差异(P <0. 05).非OSAS组中36例患者(76. 60%)诊断为NAFLD,OSAS组中57例患者(96. 61%)诊断为NAFLD,NAFLD严重程度两者差异有统计学意义(P <0. 05). ALT与肝脏脂肪含量呈正相关(r=0. 316,P=0. 000),AST与肝脏脂肪含量呈正相关(r=0. 314,P=0. 000).结论:OSAS患者相对于非OSAS患者,NAFLD的发病率及严重程度显著增高,肝脏损伤程度加重. IDEA-IQ技术对诊断OSAS患者肝脏脂肪变性及病变程度具有较高的价值. Objective:To evaluate the liver fat content and degree of disease in patients with obstructive sleep apnea hypopnea syndrome(OSAS)by using the least squares estimation method of quantitative asymmetric echoes in the magnetic resonance scan to simulate the water-lipid separation sequence(IDEAL-IQ)imaging technique.Methods:One hundred and six patients with polysomnography were selected as the study subjects.According to the monitoring results,they were divided into non-OSAS group and OSAS group.All of them were tested by IDEAL-IQ imaging technology.The general clinical data,liver fat content,laboratory test results and the grade of non-alcoholic fatty liver disease(NAFLD)were compared between the two groups,and the correlation of liver fat content and serum alanine aminotransferase(ALT)and aspartate aminotransferase(AST)was analyzed.Results:Of the 106 patients,47 were non-OSAS patients and 59 were OSAS patients.The liver fat content of patients in the non-OSAS group was(13.51±10.47)%,and that in the OSAS group was(18.49±7.90)%,which showed statistically significant difference(P<0.05).There were no significant difference between two groups in age,gender,AST,triglyceride(TG),total cholesterol(TC),and high-density lipoprotein cholesterol(HDL-C)(P>0.05).The body mass index(BMI),serum ALT,and low-density lipoprotein cholesterol(LDL-C)in OSAS group was markedly higher than those in non-OSAS group(P<0.05).In the non-OSAS group,36 patients(76.60%)were diagnosed with NAFLD,and 57 patients(96.61%)in the OSAS group were diagnosed with NAFLD.The severity of NAFLD in the two groups had significant difference(P<0.05).There was a positive correlation between liver fat content and ALT(r=0.316,P=0.000)as well as AST(r=0.314,P=0.000).Conclusion:The incidence and severity of NAFLD are significantly increased in OSAS patients when compared with non-OSAS patients,and the degree of liver damage is aggravated.IDEA-IQ technology is of high value in diagnosing liver steatosis and lesions degree in patients with OSAS.

关 键 词： 磁共振成像 阻塞性睡眠呼吸暂停 非酒精性脂肪性肝病 慢性间歇性缺氧

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