Histological indications of a progressive snorers disease in an upper airway muscle
Histological indications of a progressive snorers disease in an upper airway muscle
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DOI：
10.1164/ajrccm.157.2.96-06049
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发表时间：
1998-02-01
影响因子：
24.7
通讯作者：
Svanborg, E
中科院分区：
文献类型：
--
作者：
Friberg, D;Ansved, T;Svanborg, E
打鼾和阻塞性睡眠呼吸暂停（OSA）患者上气道阻塞的病因尚不清楚。局部肌肉异常，包括神经源性病变，可能是一个促成因素。本研究的目的是从组织学上评估进行性打鼾疾病的假设。对21例有习惯性打鼾和不同程度上气道阻塞的患者（10例OSA患者）和10例无打鼾的对照者进行腭咽肌活检。形态异常，包括神经源性体征（例如，类型分组），被盲量化。与对照组相比，患者的异常程度显著增加。异常的个体评分与周期性阻塞性呼吸的百分比显著相关，但与氧饱和度下降指数无关。对单个纤维尺寸谱的分析表明，与对照组相比，患者中肥大和/或萎缩纤维的数量显着增加。受试者还根据他们的夜间呼吸类型分为三组，即，无打鼾者、<20%的患者和大于或等于45%的阻塞性呼吸患者。这些组与异常程度和病理纤维大小谱显著相关。总之，这些结果支持打鼾创伤引起的进行性局部神经源性损伤可能是上气道可吸收性的一个促成因素的假设。
The etiology of upper airway collapsibility in patients with snoring and obstructive sleep apnea (OSA) remains unclear. Local muscular abnormalities, including neurogenic lesions, could be a contributory factor. The aim of this study was to histologically evaluate the hypothesis of a progressive snorers disease. Biopsies of palatopharyngeal muscle were obtained from 21 patients with habitual snoring and different degrees of upper airway obstruction (10 patients with OSA) and 10 nonsnoring control subjects. Morphological abnormalities, including neurogenic signs (e.g., type grouping), were blindly quantified. The degree of abnormality was significantly increased in patients compared with control subjects. The individual score of abnormalities was significantly correlated to the percentage periodic obstructive breathing but not to oxygen desaturation index. Analyses of the individual fiber-size spectra demonstrated a significantly increased number of hypertrophied and/or atrophied fibers in patients compared with controls. The subjects were also divided into three groups according to their type of nocturnal breathing, i.e., nonsnorers, patients with < 20%, and patients with greater than or equal to 45% obstructive breathing. These groups correlated significantly with the degree of abnormality and pathological fiber-size spectra. In conclusion, these results support the hypothesis of a progressive local neurogenic lesion, caused by the trauma of snoring, as a possible contributory factor to upper airway collapsibility.