| Objective: Obstructive sleep apnea hypopnea syndrome(OSAHS) is a common,but underdiagnosed disorder,which potentially is fatal.It is characterized by repetitive episodes of complete or partial upper airway obstruction leading to hypoxia and hypercapmia. Vascular endothelial growth factor (VEGF) is a hypoxia-sensitive glycoprotein stimulating neoangiogenesis.The expression of the VEGF gene is basically stimulated by hypoxia through mediation of hypoxia-inducible factor(HIF).VEGF is a potent inducer of endothelial cell growth and angiogenesis and a secreted peptide that acts specifically on vascular endothelial cells through two different high-affinity receptors,designated KDR/flk-1 and flt-1.The purpose of this research is to explore the localization of VEGF and it mRNA in the pharyngeal tissue of patients with OSAHS. In order to get new therapeutic strategies and the relationship between VEGF and degree of narrow pharyngral airway is researched.Materials and Method: The study consisted of 32 patients with OSAHS treated with UPPP and 30 healthy subjects as controls. All of them were checked by polysomnograph individually.Immunohistochemistry on paraffin sections was performed with anti-human factor Ⅷ antibody to study the microvascular density (MVD),and with antibodies to VEGF,Flt-1 and KDR to investigate the expression of these three proteins in the pharyngeal tissue.The levels of VEGF in serum in all subjects were tested by ELISA.Results:1. The serum VEGF (at 7:00 AM)in OSAHS patients is higher than that in control group(at 7:00 AM:OSAHS patients243.59±47.65pg/ml,control group124.83±3.74pg/ml, p<0.01；at 23:00 PM:OSAHS patients161.31±21.73pg/ml,control group124.5±2.97 pg/ml,p>0.05)①The content of serum VEGF and ODT/TST are in the postive linear correlation (R=0.893,P<0.01),the linear regression equation is Y=103.387＋2.922X。② The content of serum VEGF and the night mean SO2 are in the negative linear correlation (R=-0.754,P<0.01),the linear regression equation is Y=1880.796-18.128X。③ The content of serum VEGF and AHI are in the postive linear correlation(R=0.944,P<0.01),the linear regression equation is Y=113.704＋3.404X。④ The content of serum VEGF and the lowest SO2 are in the negative linear correlation (R=-0.734,P<0.01),the linear regression equation is Y=473.268-3.078X。⑤ The content of serum VEGF and BMI ,neck circumference,WHR have not correlative(P>0.01)2. The levels of serum VEGF in OSAHS patients are different in night and in moring,which in moring is higher than that in night。3. The histological and immunohistochemical feature:①Pathological changes in pharynx tissues of OSAHS patients :Subepithelia blood vessels expand and hyperemia,soft tissues edema.② Immunohistochemical changes about VEGF :There are a powerful postive expression in base and spinae stratum cells in mucosa squamous epithelium and epithelium of glandular duct of OSAHS ,a feeble postive expression in vascular endothelial cell .However,there are feeble postive expression in base and spinae stratum cells in mucosa squamous epithelium and epithelium of glandular duct of control group,a negative expression in vascular endothelial cell.③ Immunohistochemical changes about flt-1:There are a powerful postive expression in epithelium of glandular duct and in striated muscule cells of OSAHS.but there are feeble postive expression in that of control group.④ Immunohistochemical changes about KDR:There are a powerful postive expression in extrastratum cells in mucosa squamous epithelium and in striated muscule cells and epithelium of glandular duct of OSAHS patients,a feeble postive expression in some interstitial cells. However,there are feeble postive expression extrastratum cells in mucosa squamous epithelium and in striated muscule cells and epithelium of glandular duct of control group,a negative expression in interstitial cells.4. The MVD change of pharynx tissues:the MVD of OSAHS patient is higher than that of control group(OSAHS...
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