论文部分内容阅读
目的通过研究阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者腭帆张肌病理形态学改变,探讨腭帆张肌病理变化与失神经支配的关系。方法经PSG检查确诊OSAHS患者30例,通过HE、Masson、胆碱脂酶(AchE)染色及透射电镜进行腭帆张肌形态学观察和图像分析,并与10例慢性扁桃体炎患者作比较。结果OSAHS患者腭帆张肌的病理变化为肌纤维细胞萎缩,截面积减少,胶原纤维细胞增加,胶原纤维截面积增加,肌肉截面积/胶原截面积比率下降;肌纤维结构紊乱,肌丝溶解,部分Z线呈锯齿状排列,甚至消失,肌原纤维排列紊乱,肌浆网扩张,线粒体聚集,有髓鞘神经纤维水肿,髓鞘部分松解,鞘膜断裂呈葱皮样改变,出现裂隙,见大量异常颗粒沉积;运动终板数量明显减少甚至消失。结论OSAHS患者腭帆张肌中运动终板及周围神经发生了明显形态学变化,病变程度与肌肉病理变化呈正相关,OSAHS的发生发展可能与腭帆张肌失神经支配有关。
Objective To study the pathological changes of the palatal lobe muscle in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS), and to explore the relationship between the pathological changes of the palatal- Zhang Wei muscle and the denervation. Methods Thirty patients with OSAHS were confirmed by PSG examination. Morphological observation and image analysis of palatoplasty muscle were performed by HE, Masson, AchE staining and transmission electron microscopy, and compared with 10 patients with chronic tonsillitis. Results The pathological changes of palatal fan muscle in OSAHS patients were atrophy of myofibroblasts, reduction of cross-sectional area, increase of collagen fibers, increase of cross-sectional area of collagen fibers, decrease of cross-sectional area of muscle and cross-sectional area of muscle fibers; Lines were arranged in a jagged or even disappear, myofibril arranged disorder, sarcoplasmic reticulum expansion, mitochondria aggregation, myelinated nerve fiber edema, myelin partial loosening, sheath rupture was onion-like changes, the emergence of cracks, see a large number Abnormal particle deposition; the number of motor end plates decreased significantly or even disappeared. Conclusions There was a significant morphological change in the motor end plate and peripheral nerve in the lumbar muscle of OSAHS patients. The severity of OSAHS was positively correlated with the pathological changes of muscle. The occurrence and development of OSAHS may be related to the denervation of the levator mucosa.