HIF-1α、VEGF在阻塞性睡眠呼吸暂停低通气综合征患者软腭组织中的表达及其意义  

Hypoxia inducible factor-1 alpha and vascular endothelial growth factor expression in the soft palate of patients with obstructive sleep apnea hypopnea syndrome

作　　者：李浩[1] 李延忠[1] 王岩[1] LI Hao, LI Yanzhong, WANG Yan(Department of Otolaryngology, Qilu Hospital of Shandong University/Key Laboratory of Otolaryngology, NHFPC （Shandong University）, Jinan 250012, Shandong, China)

机构地区：[1]山东大学齐鲁医院耳鼻咽喉科国家卫计委耳鼻喉科学重点实验室,山东济南250012

出　　处：《山东大学耳鼻喉眼学报》2018年第2期43-47,共5页Journal of Otolaryngology and Ophthalmology of Shandong University

基　　金：国家自然科学基金项目(81170903)

摘　　要：目的通过研究阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者软腭组织中HIF-1α、VEGF的表达,探讨HIF-1α、VEGF表达与OSAHS的关系及意义。方法选取30例OSAHS患者作为实验组,6例排除OSAHS的单纯慢性扁桃体炎患者作为对照组。通过HE染色观察软腭组织中肌细胞、血管等的变化,再通过免疫组化检测软腭组织中HIF-1α和VEGF的表达。结果 (1)HE染色结果显示:实验组软腭组织中上皮细胞增生,固有层增厚,肌纤维均存在不同程度的变性,肌纤维排列紊乱,新生毛细血管生成等现象;(2)免疫组化染色结果显示:HIF-1α于OSAHS中、重度组在黏膜基底层及棘层细胞胞浆高表达,阳性表达主要定位于细胞核和细胞浆呈棕褐色。VEGF在OSAHS中、重度组软腭组织黏膜鳞状上皮基底层及棘层细胞胞浆强阳性表达,腺管上皮细胞强阳性表达或局灶强阳性表达,血管内皮细胞部分阳性表达;(3)HIF-1α、VEGF均与睡眠呼吸暂停低通气指数(AHI)呈正相关(P<0.05),与夜间最低氧饱和度呈负相关(P<0.01)。结论 OSAHS患者软腭组织中HIF-1α、VEGF的表达,与OSAHS严重程度有关,可能在其发生发展过程中起到重要作用。Objective To investigate hypoxia inducible factor-1 alpha（ HIF-1α） and vascular endothelial growth factor（ VEGF） expression in the soft palate in patients with obstructive sleep apnea-hypopnea syndrome（ OSAHS）,and to explore the role of these factors in the pathogenesis of OSAHS. Methods Immunohistochemistry was used to detect HIF-1α and VEGF expression in the soft palate of 30 patients with OSAHS（ experiment group） and six who had undergone tonsillectomy（ control group）. Results Hematoxylineosin staining of the soft palate revealed epithelial hyperplasia,thickening of the lamina propria,disordered muscle fibers in various stages of degeneration,and angiogenesis in the experimental group. Immunohistochemical staining revealed overexpression of HIF-1α in the nuclei and cytoplasm of cells in the squamous,epithelial,basal,and spinous layers,and strongly positive expression of VEGF in the cytoplasm of cells in the squamous,epithelial,basement,and stratum spinosum layers of the soft palate mucosa in patients with moderate to severe OSAHS. VEGF showed focal positive expression in glandular epithelial cells and vascular endothelial cells. HIF-1α and VEGF expression was positively correlated with the apnea-hypopnea index（ P0.05） and negatively correlated with the lowest nocturnal oxygen saturation（ P0.01）. Conclusion Pathologic changes in the soft palate of patients with OSAHS were strongly correlated with the degree of hypoxia. HIF-1α and VEGF may play an important role in the development of OSAHS.

关 键 词：睡眠呼吸暂停 阻塞性 软腭组织 缺氧诱导因子-1Α 血管内皮生长因子 免疫组织化学 

分 类 号：R766.7[医药卫生—耳鼻咽喉科]