| 摘要: |
| 目的:观察持续气道正压通气（CPAP）对阻塞性睡眠呼吸暂停综合征（OSAS）小型猪血清NO、血浆ET浓度及心肌组织结构的影响。方法:24只雄性成年中国小型猪随机分为正常对照组、OSAS模型组、CPAP 治疗组及阳性对照组共4组（n=6）。后3组均给予22 d、6 h/d的间歇性低压低氧处理制备OSAS 模型，CPAP治疗组给予连续30 d、6 h/d的CPAP治疗，阳性对照组制模成功后继续饲养30 d后与CPAP治疗组同时处死，正常对照组与OSAS模型组同时处死。各组处死前均行睡眠监测和血浆ET、血清NO浓度测定，死后取心肌组织行病理学检查。结果:CPAP治疗组较OSAS模型组、阳性对照组低通气指数(AHI)显著降低（P<0.05）、血氧饱和度(SpO2)显著上升（P<0.05）；较正常对照组AHI显著增高（P<0.05），SpO2无统计学差异。正常对照组、OSAS模型组、CPAP 治疗组及阳性对照组猪血清NO浓度（μmol/L）分别为:0.221±0.062、0.110±0.033、0.115±0.061、0.077±0.043，血浆ET浓度（pg/ml）分别为:40.2±4.8、99.8±22.4、67.1±18.5、103.7±30.1。CPAP治疗组较阳性对照组NO浓度上升、ET浓度下降，较模型组ET浓度下降（P均<0.05）。心肌组织病理:模型组、CPAP治疗组、阳性对照组心肌组织较正常对照组均发生低氧缺血损害；CPAP治疗组心肌组织病变程度较模型组、阳性对照组轻，较正常对照组重。结论:30 d的CPAP治疗可以改善OSAS小型猪睡眠监测指标，血浆ET、血清NO浓度，及心肌组织的病变。 |
| 关键词: 阻塞性睡眠呼吸暂停综合征 持续气道正压通气 动物模型 内皮素 一氧化氮 心肌 病理学 |
| DOI：10.3724/SP.J.1008.2009.0680 |
| 投稿时间：2008-11-07修订日期：2009-01-19 |
| 基金项目:国家自然科学基金（30370378）. |
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| Effect of continuous positive airway pressure on myocardial structure and plasma NO and ET in mini pigs with obstructive sleep apnea syndrome |
| ZHAO Li-ming1, Li Bing1*, XIU Qing-yu1,SHEN Jun2,ZHANG Hui2, LIU Qiu-hong2 |
| (1.Department of Respiratory Medicine,Changzheng Hospital, Second Military Medical University, Shanghai 200003, China;2.Aeromedicine Laboratory,Institute of Naval Medicine,Shanghai 200433) |
| Abstract: |
| Objective:To investigate the effect of continuous positive airway pressure (CPAP) on serum NO and plasma ET and myocardial structure in mini pigs with obstructive sleep apnea syndrome (OSAS).Methods: Twenty-four male mini pigs were evenly randomized into 4 groups: normal control group (group A), OSAS model group (group B), CPAP treated group (group C) and positive control group (group D).Animals in group A were not treated and those in the other 3 groups were treated with intermittent hypobaric hypoxia 6 h daily for 22 d.Animals in groups C was also given further CPAP treatment 6 h daily for 30 d.The animals in group D were raised for 30 d and were sacrificed together with those in group C; the animals in group A and group B were sacrificed simultaneously.Sleep monitoring and determination of serum NO and plasma ET were performed before execution and pathological examination of myocardial structure after execution.Results: The apnea-hypopnea index (AHI) of group C was significantly lower than those of group B and D and higher than that of group A (P<0.05); the SpO2 of group C was significantly higher than those of group B and D (P<0.05), and was similar to that of group A.The levels of NO in group A, B, C, and D were (0.221±0.062), (0.115±0.061), (0.110±0.033), (0.077±0.043) μmol/L, respectively, and the levels of ET were (40.2±4.8), (99.8±22.4), (67.1±18.5), and (103.7±30.1) pg/ml, respectively.Group C had significantly higher NO level and lower ET level compared with group D (P<0.05).The ET level in group C was significantly lower than that in group B (P<0.05).Pathological examination showed that the myocardial structure in group B, C, and D all had hypoxia and ischemia damage compared with group A; the damage in group C was slighter than that in group B and D, but severer than that in group A.Conclusion: Thirty day-treatment with CPAP can improve the sleeping indices, plasma ET and serum NO level, and myocardial structure of OSAS mini pigs. |
| Key words: obstructive sleep apnea syndrome continuous positive airway pressure animal model endothelin nitric oxide cardiac muscle pathology |
