下颌前移矫治器治疗阻塞性睡眠呼吸暂停对颏舌肌线粒体超微结构的影响  

Effect of mandibular advancement device on mitochondrial ultrastructure of the genioglossus in the treatment of obstructive sleep apnea

作　　者：苑茜茜 赵紫瑞 张妍妍 黄钰 石凯凯 范登莹 朱亚慧 刘春艳[2] Yuan Xixi;Zhao Zirui;Zhang Yanyan;Huang Yu;Shi Kaikai;Fan Dengying;Zhu Yahui;Liu Chunyan(School of Stomatology,Hebei Medical University,Shijiazhuang 050000,Hebei Province,China;Department of Orthodontics,Hospital of Stomatology,Hebei Medical University,Hebei Key Laboratory of Stomatology,Hebei Clinical Research Center for Oral Diseases,Shijiazhuang 050000,Hebei Province,China)

机构地区：[1]河北医科大学口腔医学院,河北省石家庄市050000 [2]河北医科大学口腔医院正畸科,河北省口腔医学重点实验室,河北省口腔疾病临床医学研究中心,河北省石家庄市050000

出　　处：《中国组织工程研究》2022年第35期5626-5632,共7页Chinese Journal of Tissue Engineering Research

基　　金：国家自然科学青年基金项目(81701010),项目负责人:刘春艳;河北省教育厅青年基金项目(QN2017109),项目负责人:刘春艳。

摘　　要：背景:目前阻塞性睡眠呼吸暂停的常用治疗方法为下颌前移矫治器,学者对颏舌肌功能异常可以引发阻塞性睡眠呼吸暂停发病已经达成共识,但对于引起颏舌肌损伤和功能障碍的机制以及相关治疗方法对颏舌肌的影响关注不足。目的:探讨下颌前移矫治器治疗阻塞性睡眠呼吸暂停对颏舌肌线粒体超微结构的保护作用,分析阻塞性睡眠呼吸暂停致颏舌肌结构功能紊乱是否与氧化应激有关。方法:将30只兔随机分为对照组、阻塞性睡眠呼吸暂停组和下颌前移矫治器组,后两组构建阻塞性睡眠呼吸暂停模型,下颌前移矫治器组佩戴下颌前移矫治器。建模成功后诱导3组兔仰卧位睡眠。CT扫描观察上气道结构变化,多导睡眠图监测血氧饱和度和呼吸睡眠指标变化。8周后制备颏舌肌透射电镜标本,观察其组织超微结构;用硫代巴比妥酸法测颏舌肌组织内丙二醛水平,酶联免疫吸附测定法测血浆及颏舌肌组织内8-异前列腺素水平;严格按照试剂盒说明书检测谷胱甘肽水平及过氧化氢酶、总超氧化物歧化酶、铜锌超氧化物歧化酶、锰超氧化物歧化酶和琥珀酸脱氢酶活性。结果与结论:(1)对照组线粒体形态结构正常,阻塞性睡眠呼吸暂停组严重破坏;下颌前移矫治器组较阻塞性睡眠呼吸暂停组明显减轻,接近对照组;(2)阻塞性睡眠呼吸暂停组8-异前列腺素水平明显高于对照组(P<0.05),丙二醛水平明显高于其余两组(P<0.05),总超氧化物歧化酶、铜锌超氧化物歧化酶和锰超氧化物歧化酶活性均低于其余两组(P<0.05);谷胱甘肽水平、过氧化氢酶和琥珀酸脱氢酶活性均明显低于对照组(P<0.05);(3)以上指标下颌前移矫治器组与对照组相比差异无显著性意义(P>0.05);(4)提示阻塞性睡眠呼吸暂停所致的颏舌肌线粒体结构损伤与氧化应激有关,下颌前移矫治器可预防或缓解阻塞性睡眠呼吸暂停所致颏舌BACKGROUND:At present,the common treatment method for obstructive sleep apnea is mandibular advancement device.Scholars have reached a consensus that the abnormality of the genioglossus muscle can cause obstructive sleep apnea.Howeve r,insufficient attention has been paid to the mechanism that causes genioglossus muscle damage and dysfunction and the impact of relevant treatment methods on the genioglossus muscle.OBJECTIVE:To evaluate the effects of mandibular advancement device for obstructive sleep apnea on the genioglossus ultrastructure and explo re whether oxidative stress pathway is the mechanism of obstructive sleep apnea causing skeletal muscle structure and function disorders.METHODS:Thirty rabbits were divided into three groups:control,obstructive sleep apnea,and mandibular advancement device groups.Rabbit models of obstructive sleep apnea were established in the latter two groups.Three days after modeling,all rabbits were induced to sleep in supine position.CT scans were performed to examine the changes in upper airway structure and polysomnography was used to monitor changes in blood oxygen saturation and res pirato ry sleep index.After 8 wee ks,the ultrastructure of the genioglossus muscle was detected under transmission electron microscope.The level of malondialdehyde in the genioglossus muscle was measured by the thiobarbituric acid method,and the levels of 8-isoprostaglandin in the plasma and genioglossus muscle were measured by the enzyme-lin ked immunosorbent assay method.The level of glutathione and activities of catalase,total superoxide dismutase,copper-zinc superoxide dismutase,manganese superoxide dismutase,and succinate dehydrogenase were measured in strict accordance with the kit instructions.RESULTS AND CONCLUSION:The morphology and structure of genioglossus mitochondria were normal in the control group,and we re seriously damaged in the obstructive sleep apnea group.Compared with the control group,the obstructive sleep apnea group had a higher level of 8-isoprostaglandin(P<0.05);the lev

关 键 词：下颌前移矫治器 阻塞性睡眠呼吸暂停 颏舌肌 线粒体结构 氧化应激 谷胱甘肽 过氧化氢酶 超氧化物歧化酶 琥珀酸脱氢酶 

分 类 号：R459.9[医药卫生—治疗学] R318[医药卫生—临床医学]