阻塞性睡眠呼吸暂停低通气综合征患者腭咽组织病理学观察

The observation of palatopharyngeal histopathologic characteristic on the patients with obstructive sleep apnea-hypopnea syndrome

目的:观察阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者腭咽组织病理学变化特点,探讨腭咽组织中脂质异位积累在OSAHS发生、发展机制中的作用。方法:以OSAHS患者(OSAHS组)和无鼾症患者(对照组)各19例为研究对象,按体质指数(BMI)配对研究。取2组软腭及咽腭弓组织分别用苏木精-伊红及油红-O脂肪染色,镜下观察2组腭咽组织病理学特点及脂质异位积累情况。结果:OSAHS组腭咽组织中存在明显的脂质浸润,同时伴有小唾液腺类型改变,其超微结构呈现相应变化及细胞缺氧性改变;对照组腭咽组织无异常改变。结论:脂质在腭咽组织中的异位积累可能是导致OSAHS患者睡眠时咽部气道塌陷的重要原因,与OSAHS的发生、发展关系密切。

Objective：To observe the histopathologic characteristic of the palatopharyngeal tissue and study the effect of ectopic accumulation of lipid on the pathogenesis and development of OSAHS. Method： Thirty-eight cases were selected from the patients in hospital and divided into two groups. Each group had 19 cases, coupled according to Body Mass Index （BMI）. HE staining, Oil red O lipid staining and the electro microscope technology were used to observe the pathologic characteristic of the palatopharyngeal tissue, especially the ectopic accumulation of lipid. Result： There existed obvious fatty infiltration in the palatopharyngeal tissue of OSAHS patients, and the type of the minor salivary glands changed. The ultrastructure showed the corresponding changes and the cellular anoxic changes. Conclusion：Fatty infiltration in the palatopharyngeal tissue of OSAHS patients may play an important role in the pharyngeal airway sinking during sleep. There is a closely correlated between fatty infiltration and the pathogenesis and development of OSAHS.