阻塞性睡眠呼吸暂停低通气综合征患者悬雍垂超微结构改变的研究  

Ultrastructure changes of uvula in obstructive sleep apnea hypopnea syndrome

作　　者：逄明杰[1] 孙炜[2] 李娜[2] 孙彦[2] 

机构地区：[1]青岛市立医院,山东青岛266011 [2]青岛大学医学院

出　　处：《山东大学基础医学院学报》2005年第2期73-75,共3页Journal of Preclinical Medicine College of Shandong Medical University

摘　　要：目的:探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者悬雍垂超微结构改变与呼吸紊乱指数、血氧饱和度的相关性。方法:以软腭水平阻塞为主的阻塞性睡眠呼吸暂停低通气综合征患者悬雍垂30例为实验组,取无OSAHS发病史及相关疾病的尸检悬雍垂15例为对照组。于电镜下观察其超微结构,并用半定量分析法进行数据分析。结果:电镜下见OSAHS组线粒体、肌原纤维及生物膜结构不同程度地受损,Flameng评分和对照组差异有显著性(P <0 .0 5 ) ,OSAHS组内Flameng评分与呼吸紊乱指数、血氧饱和度及最低血氧饱和度相关(r=0 .6 4,r=- 0 .72 ,r=- 0 .6 4,P<0 .0 5 )。结论:线粒体、肌原纤维等超微结构的改变,导致肌张力下降、咽壁顺应性增高,是加重腭咽水平OSAHS者缺氧的重要原因。Objective:To investigate the ultrastructure changes of uvula and their correlation with AHI,and SaO 2 in obstructive sleep apnea hypopnea syndrome (OSAHS). Methods: Thirty cases of OSAHS mainly obstructed at the soft palate level were selected and resected the uvulas by palatopharyngoplasty as experiment group;15 cases without OSAHS and related diseases were selected as control group.Their ultrastructure were observed under electron microscope. Results: Electron microscopy showed that the crests of the mitochondrias broken and lysed, the granules of the matrix lost obviously, and the completeness of the inner and outer membranes disappeared; the Flameng score between experiment group and control group was statistical different (P<0.05); the Flameng score correlated with AHI, SaO 2 and minimum SaO 2 in experiment group(r=0.64, r= -0.72, r= -0.64 respectively, P<0.05). Conclusion:The ultrastructural changes of mitochondria, myofibril result in the descent of the muscle tension, the increase of pharynx wall′s compliance and the constriction of respiratory tract, make the airway cave in easily, and are the main causes of aggravating the ischemia of OSAHS patients obstructed at the soft palate level.

关 键 词：睡眠呼吸暂停综合征 线粒体 悬雍垂 超微结构 呼吸障碍 

分 类 号：R766.7[医药卫生—耳鼻咽喉科]