持续气道正压通气对阻塞性睡眠呼吸暂停综合征小型猪血浆NO、ET浓度及心肌结构的影响  

Effect of continuous positive airway pressure on myocardial structure and plasma NO and ET in mini pigs with obstructive sleep apnea syndrome

作　　者：赵黎明[1] 李兵[1] 修清玉[1] 沈俊[2] 张慧[2] 刘秋红[2] 

机构地区：[1]第二军医大学长征医院呼吸内科,上海200003 [2]海军医学研究所航空医学研究室,上海200433

出　　处：《第二军医大学学报》2009年第6期680-683,共4页Academic Journal of Second Military Medical University

基　　金：国家自然科学基金(30370378)~~

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22d、6h/d的间歇性低压低氧处理制备OSAS模型,CPAP治疗组给予连续30d、6h/d的CPAP治疗,阳性对照组制模成功后继续饲养30d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:30d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。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 N

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 

分 类 号：R56[医药卫生—呼吸系统]