高原低氧地区藏族脂肪肝CT分析

CT analysis of fatty liver in Xizang plateau

目的探讨高原低氧环境地区藏族脂肪肝发生的原因及CT表现．方法作者回顾性地分析了脂肪肝患者38例的CF资料．男29例，女9例，年龄25岁～60岁结果在38例患者中35例呈弥漫性浸润改变，3例呈局灶性或不规则改变.根据CT中肝密度减低程度、肝脾CT值之比、肝内血管显示、肝表面腹膜显影程度将脂肪肝分为3级：Ⅰ级15例（39．4％），Ⅱ级7例（18．4％），Ⅲ级16例（42．1％）．结论Ⅲ级脂肪肝比例最高、Ⅰ级次之、Ⅱ级最低．原因：①首次行CT检查的患者并不是以肝脏为检查目的，而是将与肝脏相近的断面脏器作为检查对象；②西藏高原低氧环境地区缺氧，导致NADH与NAD比值增高，抑制三羧酸循环，促进脂肪在肝细胞内沉积，NADH还原为NAD耗费更多的氧；③藏族具有饮酒习惯，对肝脏的早期损害即就是脂肪肝．

AIM To study the causes of fatty liver in tibetan at high altitude with hypoxic environment.METHODS We retrospecively analyzed the CT materials of 38 cases with fatty infiltration of the liver.RESULTS There were 35 patients with diffuse fatty infiltration of the liver and 3 patients with local fatty infiltration of the liver. According to the reduced degree of hepatic intensity, the ratio of CT attenuation value of liver to spleen, the degree of hepatic blood vessel revelation and the degree of revelation of peritoneum which surround the outside of the liver, the fatty infiltration of the liver was divided into three grades.There were 15 patients (39.4%) in grade Ⅰ; 7 (18.4% ) in grade Ⅱ and 16 (42.1%) in grade Ⅲ. Ⅲ grade fatty infiltration of the liver of had the highest incidence and Ⅱgrade had lowest. The incidence of grade Ⅰ was between grade Ⅱ and grade Ⅲ.CONCLSION Firstly, the organs near the liver in grade Ⅰ patients are regarded as the aim to be examined,Secondly, the hypoxic environment at high altitude can increase the ratio of NADH to NAD and inhibit the tricarboxylic acid cycle, leading to fatty deposit in liver cell. Thirdly, the Tibetan patients have the habit to drink alcohol, their livers are easily damaged and finaly result in fatty liver.