Морфологические особенности слизистой оболочки пищевода у пациентов с гастроэзофагеальной рефлюксной болезнью, ассоциированной с синдромом обструктивного апноэ/гипопноэ сна

Abstract

Nowadays the morphological features of esophageal mucosa damage in patients with the gastroesophageal reflux disease (GERD) and the obstructive sleep apnea/hypopnea syndrome (OSAHS) are not completely researched. The objective of the study was to determine the morphological features of esophageal mucosa damage in patients with GERD and OSAHS. 143 patients underwent esophagogastroduodenoscopy with biopsy of the lower third of the esophagus and respiratory monitoring. Patients were divided into 4 groups: group 1 – patients with GERD, group 2 – patients with GERD and OSAHS, group 3 – with OSAHS, group 4 – comparison group. Morphological examination with morphometric assessment of epithelium thickness, height of connective tissue papillae, internuclear distances and intercellular spaces was performed. Patients with GERD are characterized by a large thickness of the epithelium, higher connective tissue papillae, wider internuclear spaces in epithelium layers, enlarged intercellular spaces in the epithelium of the esophagus in contrast to the patients of the comparison group. Patients with GERD and OSAHS have a more pronounced epithelium thickness and wider internuclear distances in the prickly layer of the epithelium compared with patients with GERD, the high connective tissue papillae with dilated capillaries and signs of microangiopathy, sclerotic changes in the mucosa of the esophagus are determined. The obtained data show that patients with GERD and OSAHS had more pronounced epithelial disorganization in comparison with patients with GERD without OSAHS.