下颌前移矫治器治疗阻塞性睡眠呼吸暂停大白兔对舌下神经影响  

Effects of mandibular advancement device on the hypoglossal nerve in the treatment of obstructive sleep apnea in rabbits

作　　者：乔星 康文静 张士珑 马文盛 刘春艳 卢海燕 QIAO Xing;KANG Wen-jing;ZHANG Shi-long;MA Wen-sheng;LIU Chun-yan;LU Hai-yan(Department of Orthodontics, the School of Stomatology, Hebei Medical University, The Key Laboratory of Stomatology, Hebei Stomatology Clinical Medical Reserach Center, Shijiazhuang 050017, China)

机构地区：[1]河北医科大学口腔医学院,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,河北石家庄050017

出　　处：《河北医科大学学报》2022年第4期381-385,共5页Journal of Hebei Medical University

基　　金：河北省自然科学基金和重点基础研究专项(H2019206668,H2020206465)。

摘　　要：目的通过建立阻塞性睡眠呼吸暂停(obstructive sleep apnea,OSA)新西兰大白兔动物模型研究OSA及其下颌前移矫治器(mandibular advancement device,MAD)治疗对舌下神经结构及功能影响,为进一步研究舌下神经与OSA精准治疗提供理论基础。方法18只6月龄雄性新西兰大白兔随机分为对照组、OSA组、MAD组。每日诱导其仰卧位睡眠2 h,持续8周后行全麻术,钝性分离并暴露一侧舌下神经与颏舌肌,采用信号采集与处理系统,泰盟BL-420F:记录刺激舌下神经引起颏舌肌收缩的阈强度、刺激舌下神经强度为0.5 V时颏舌肌单收缩能力及刺激舌下神经引起其收缩的潜伏期。比较3组的阈强度、颏舌肌收缩张力和潜伏期。另一侧制取舌下神经组织标本,显微镜下观察神经纤维组织结构。结果OSA组阈刺激高于对照组与MAD组,颏舌肌收缩张力低于对照组与MAD组,潜伏期长于对照组与MAD组(P<0.05),对照组与MAD组阈刺激、颏舌肌收缩张力、潜伏期比较差异无统计学意义(P>0.05)。对照组的神经纤维未见明显的变化,神经纤维组织结构完整,细胞呈层状排列,神经纤维组织结构排列紧密,未见明显的液化变性、坏死。OSA组舌下神经纤维可见不同程度的变性,表现为神经纤维排列紊乱,可见溶解变性,甚至出现凝聚。MAD组神经纤维排列紊乱及变性程度均较OSA组轻。结论OSA可降低兔舌下神经传导性能及颏舌肌的收缩张力;导致舌下神经纤维排列紊乱,甚至发生变性。下颌前移矫治可降低OSA对舌下神经的损伤程度,发挥对舌下神经的保护作用。Objective To study obstructive sleep apnea(OSA)and the effect of mandibular advancement device(MAD)on the structure and function of the hypoglossal nerve by establishing a New Zealand white rabbit model of obstructive sleep apnea(OSA),in order to provide a theoretical basis for the further study of hypoglossal nerve and precision treatment of OSA.Methods Eighteen 6-month-old male New Zealand white rabbits were randomly divided into control group,OSA group and MAD group.The rabbits were induced to sleep in supine position for 2 h every day,and general anesthesia was performed after 8 weeks.One side of hypoglossal nerve and genioglossal muscle were passively separated and exposed.Using signal acquisition and processing system,Taimeng BL-420F,the threshold intensity of genioglossal muscle contraction caused by stimulating hypoglossal nerve,the single contraction ability of genioglossal muscle when stimulating hypoglossal nerve intensity was 0.5 V and the latency of genioglossal muscle contraction caused by stimulating hypoglossal nerve were recorded.The threshold intensity,genioglossus contraction tension and latency of the three groups were compared.The hypoglossal nerve tissue specimen was prepared on the other side,and the tissue structure of nerve fibers was observed under optical microscope.Results The threshold stimulation in OSA group was higher than that in control group and MAD group,the genioglossus contraction tension was lower than that in control group and MAD group,and the latency was longer than that in control group and MAD group(P<0.05).There was no significant difference in threshold stimulation,genioglossus contraction tension and latency between control group and MAD group(P>0.05).The nerve fibers in the control group had no obvious changes,the nerve fiber tissue structure was complete,the cells were arranged in layers,the nerve fiber tissue structure was closely arranged,and there was no obvious liquefaction,degeneration and necrosis.In OSA group,the hypoglossal nerve fibers showed degeneration

关 键 词：睡眠呼吸暂停 阻塞性 舌下神经 下颌前移矫治器 

分 类 号：R749.79[医药卫生—神经病学与精神病学]