低压低氧诱导大鼠阻塞性睡眠呼吸暂停综合征后咽部肌肉结构和功能的改变
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国家自然科学基金(30370378).


Structural and functional changes of pharyngeal muscle in rats with altitude hypoxia-induced obstructive sleep apnea syndrome
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    摘要:

    目的:观察低压低氧诱导大鼠阻塞性睡眠呼吸暂停综合征(obstructive sleep apnea syndrome,OSAS)后大鼠咽部肌肉结构和功能的变化,探讨咽腔重建以及OSAS形成可能的生物力学机制.方法:24只成年SD大鼠,雌雄各半,分为低压低氧诱导雄鼠(A)组、对照雄鼠(B)组、低压低氧诱导雌鼠(C)组、对照雌鼠(D)组,共4组(n=6).低压低氧诱导组(A、C)大鼠每天6 h,连续22 d进入低压氧仓(压力53.9 kPa,氧浓度10%~11.2%),对照组(B、D)不接受低压低氧诱导.低压低氧诱导完成后(实验第23天)处死全部大鼠,行咽肌环张开角、咽肌环内径、咽部组织病理检查.结果:A、B、C、D组大鼠咽肌环张开角分别为:(55±24)°、(15±8)°、(38±20)°、(35±15)°;内径分别为:(0.4±0.2)、(0.2±0.1)、(0.3±0.1)、(0.3±0.1)cm.A组咽肌环张开角、内径较B、C、D组明显增大(P<0.05),C、D组间无明显区别.光镜下可见:A组咽肌肌纤维肥大、排列紊乱,横纹模糊不清,上皮下组织充血水肿、炎症细胞浸润;C组可见局部横纹不清;B、D组肌纤维排列整齐,上皮下组织无炎症.电镜下可见:A组肌原纤维结构紊乱、肌丝溶解,部分Z带呈锯齿状排列、有断裂消失,肌质网囊状扩张、空泡样变性,肌细胞核轻度固缩;C组可见局部肌丝溶解.结论:22 d间歇性低压低氧诱导可能通过改变咽肌结构和功能,重建咽腔,从而诱导大鼠OSAS形成.

    Abstract:

    Objective:To observe the changes of structure and function of pharyngeal muscle in SD rats with altitude hypoxia induced obstructive sleep apnea syndrome (OSAS) , in an attempt to investigate the remodeling of pharyngeal space and the possible biomechanical mechanism of OSAS. Methods: Twenty-four SD rats( 12 male and 12 female) were randomly assigned to 4 groups with 6 rats in each group. Rats in group A and B were male and those in group C and D were female. Rats in group A and C were placed in altitude chamber and treated with altitude hypoxia 6 h per day for 22 days. The pressure in the chamber was 53.9 kPa with an oxygen concentration of 10.0%-11.2%. Rats in group B and D, serving as controls, received no treatment. All rats were sacrificed on the 23^rd day. The open-angle and the inside diameter of rats' pharyngeal-ring and the pathology of pharyngeal tissues were examined in all rats. Results: The open-angles of rats' pharyngeal-ring of group A, B, C and D were (55±24)°, ( 15±8)°, (38±20)°, and (35 ± 15)°, respectively; and the inside diameters of the pharyngeal-ring(cm) were 0.4±0.2, 0.2±0.1, 0.3±0.1, and 0.3±0. 1, respectively. The open-angle and the inside diameter of rats' pharyngeal-ring in group A were significantly higher (P〈0.05) than those of group B, C, and D, with no significant difference found between group C and D. Microscopic findings showed that, compared with group B, the muscle fibers of group A were fatter and were arranged disorderly, with unclear transverse striation, dropsical and congestive subcutaneous tissues infiltrated with inflammatory cells. Local unclear transverse striation of muscle fiber was seen in group C; the muscle fibers in group B and D were orderly arranged and no inflammatory cells were seen subcutaneously, Electron microscope showed disarranged muscle fibers with dissolved myofilament, disturbance and disappearance of the Z line in part of muscle fibers, expanded sarcoplasmic reticulum, and slightly condensed muscle cell nuclei. Local myofilament dissolving was found in group C. Conclusion: Twenty-two days' intermittent altitude hypoxia can induce OSAS in SD rats through changing the structure and function of pharyngeal muscle and remodeling the pharyngeal space

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