Panek Justyna, Reszeć Joanna, Rogowski Marek, Olszewska Ewa
Klinika Otolaryngologii, Uniwersytet Medyczny w Białymstoku.
Zakład Patomorfologii Lekarskiej, Uniwersytet Medyczny w Białymstoku.
Otolaryngol Pol. 2019 Dec 5;74(1):6-12. doi: 10.5604/01.3001.0013.6199.
Introduction Sleep is a physiological state essential for proper functioning of the body. One of the reasons for sleep disorders is obstructive sleep apnea syndrome (OSAS).
The aim of this research is histological evaluation of the mucous membrane of the soft palate in patients affected by various forms of OSAS.
The studied group consisted of patients with sleep-related breathing disorder in the form of primary snoring or OSAS. People with chronic tonsillitis, without a history of sleep-related breathing disorders, were included in the comparative group. Fragments of the mucous membrane of the uvula (study group) and the glossopalatine arch (comparative group) were taken for histological examination during surgery. Using histological, histochemical and immunohistochemical methods, we assessed the presence and severity of inflammation (CD3, CD20, CD68), the structure of nerve fibers (S-100) and the size of blood vessels (CD34) in the examined tissue.
Patients with OSAS developed a local inflammatory process in the oropharyngeal tissues (stronger expression of CD3, CD20, CD68 in people with OSAS). The exacerbation of the immunohistochemical reaction with CD3 correlated with the phase of OSAS. We found a higher degree of fibrosis and a higher expression of CD34 and S-100 receptors in subjects with OSAS compared to snoring patients and patients from the comparative group.
Due to chronic tissue vibration, snoring most likely leads to damage to the nerve fibers in the soft palate, which can intensify episodes of shallow breathing during sleep and increase the occurrences of apnea.
引言 睡眠是身体正常运作所必需的生理状态。睡眠障碍的原因之一是阻塞性睡眠呼吸暂停综合征（OSAS）。
本研究的目的是对受各种形式OSAS影响的患者软腭黏膜进行组织学评估。
研究组由以原发性打鼾或OSAS形式存在睡眠相关呼吸障碍的患者组成。将患有慢性扁桃体炎且无睡眠相关呼吸障碍病史的人纳入对照组。在手术期间采集悬雍垂黏膜碎片（研究组）和舌腭弓黏膜碎片（对照组）进行组织学检查。我们使用组织学、组织化学和免疫组织化学方法评估了所检查组织中炎症（CD3、CD20、CD68）的存在和严重程度、神经纤维结构（S-100）以及血管大小（CD34）。
OSAS患者在口咽组织中出现局部炎症过程（OSAS患者中CD3、CD20、CD68的表达更强）。CD3免疫组织化学反应的加剧与OSAS阶段相关。与打鼾患者和对照组患者相比，我们发现OSAS患者的纤维化程度更高，CD34和S-100受体的表达更高。
由于慢性组织振动，打鼾很可能导致软腭神经纤维受损，这会加剧睡眠期间的浅呼吸发作并增加呼吸暂停的发生率。
