不同程度OSAHS患者腭咽软组织病理形态学改变

发布时间：2018-04-25 16:02

本文选题：睡眠呼吸暂停低通气综合征 + 阻塞性　；参考：《临床耳鼻咽喉头颈外科杂志》2012年24期

【摘要】：目的:了解不同程度阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者腭咽软组织的病理形态学改变特点。方法:OSAHS患者38例,均为男性,分为轻度组(10例)、中度组(13例)和重度组(15例),对手术切除的软腭及部分腭咽弓、腭舌弓组织常规石蜡包埋,苏木精-伊红染色,100倍光学显微镜观察。对软腭标本中腺体、脂肪及间质所占比例进行测量计算。结果:①随OSAHS程度加重:软腭黏膜鳞状上皮细胞肿胀,形态不规则,过度角化,基底层细胞液化变性;在黏膜层及黏膜下疏松结缔组织中可见炎细胞浸润,并可见大量脂肪空泡;软腭黏液性腺泡大小不一致,形态不规则,腺泡间可见脂肪细胞浸润,部分黏液性腺泡被浆液性腺泡所取代;腭舌弓及腭咽弓肌纤维排列紊乱,结构模糊不清,呈多形性改变,包括肿胀、萎缩和退行性变,部分弹性纤维中断,可见大量脂肪细胞浸润。②轻、中、重度三组OSAHS患者软腭3种成分构成比,腺体及间质成分组间差异有统计学意义(P0.05),血管成分在轻、中度组间差异无统计学意义(P0.05),在轻、重度以及中、重度组间差异有统计学意义(P0.05)。结论:随OSAHS患者病情加重,软腭黏膜鳞状上皮细胞肿胀过度角化;腺泡大小形态明显不规则并出现浆液性腺泡和脂肪细胞浸润;咽肌纤维出现肿胀、萎缩和退行性变。
[Abstract]:Objective: to investigate the pathomorphological changes of palatopharynx soft tissue in patients with obstructive sleep apnea hypopnea syndrome (OSAHS). Methods 38 cases of OSAHS, all male, were divided into mild group (n = 10) and moderate group (n = 13) and severe group (n = 15). Observation of hematoxylin-eosin staining with 100 times optical microscope. The proportion of glands, fat and stroma in soft palate was measured and calculated. Results with the severity of OSAHS, the squamous epithelial cells of soft palate mucosa were swollen, irregular, hyperkeratosis, liquefaction and degeneration of basal layer cells, inflammatory cell infiltration was observed in loose connective tissue of mucous membrane and submucous membrane. A large number of fat vacuoles can be seen. The size of soft palate mucinous acinus is different, the shape is irregular, fat cells infiltrate between acinus, some mucinous acinus is replaced by serous acinus, and the fibers of palatoglossal arch and palatopharynx arcuate muscle are disordered. The structure was vague and varied, including swelling, atrophy and degenerative changes, partial disruption of elastic fibers, large number of fat cells infiltrating .2 light, moderate and severe OSAHS patients with three components of the soft palate composition ratio, There were significant differences in glandular and interstitial components between the two groups (P 0.05), while there was no significant difference in vascular composition between mild and moderate groups (P 0.05), but there was significant difference between mild, severe and moderate and severe groups (P 0.05). Conclusion: with the aggravation of OSAHS, soft palate squamous epithelium is swollen and hyperkeratosis, acinus size is irregular and serous acinar and adipocyte infiltrate, pharyngeal muscle fiber is swollen, atrophy and degenerative.
【作者单位】：中国医科大学附属第一医院耳鼻咽喉科;北京世纪坛医院耳鼻咽喉头颈外科;
【分类号】：R766

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