脑源性神经营养因子与阻塞性睡眠呼吸暂停综合征患者软腭肌失神经改变的相关性研究  

Relationship between brain-derived neurotrophic factor and denervation of soft palate muscle in patients with obstructive sleep apnea syndrome

作　　者：李蒙蒙 唐青来[1] 杨新明[1] 曾诗颖 黄佩颖 蒋康 李仕晟[1] LI Mengmeng;TANG Qinglai;YANG Xinming;ZENG Shiying;HUANG Peiying;JIANGKang;LI Shisheng(Department of Otolaryngology Head and Neck Surgery,the Second Xiangya Hospital,Central SouthUniversity,Changsha,Hunan,410000,China)

机构地区：[1]中南大学湘雅二医院耳鼻咽喉头颈外科,湖南长沙410000

出　　处：《中国耳鼻咽喉头颈外科》2022年第9期557-562,共6页Chinese Archives of Otolaryngology-Head and Neck Surgery

基　　金：国家自然科学基金(81870711);湖南省自然科学基金(2020JJ4791、2019JJ60078)。

摘　　要：目的 本研究通过观察脑源性神经营养因子(brain-derived neurotrophic factor,BDNF)在阻塞性睡眠呼吸暂停综合征(OSAS)患者软腭肌中的分布特点及表达水平,旨在探究BDNF与OSAS患者软腭肌失神经改变的相关性。方法 将45例研究对象分为轻中度OSAS组(15例)、重度OSAS组(18例)、对照组(12例)。光镜下观察患者软腭肌形态结构特征,免疫荧光观察软腭肌BDNF分布特点,ELISA检测样本中BDNF的含量,Western blot检测样本中高分子量神经微丝蛋白(high molecular weight neurofilament protein,NFH)的含量并进行统计分析。结果重度OSAS组软腭肌肌纤维排列紊乱,部分呈失神经后改变;与轻中度OSAS组及对照组比较,重度OSAS组软腭肌上BDNF分布更为紊乱,其表达水平显著高于对照组(P=0.001)。轻中度OSAS组软腭肌NFH表达水平低于对照组(P=0.022)。BDNF的表达水平与呼吸暂停低通气指数(AHI)呈正相关(r=0.417,P=0.016),与NFH之间未见明显相关性。结论 BDNF在OSAS患者软腭肌失神经改变中具有重要作用。BDNF表达水平增高可能会加重OSAS患者软腭肌形态结构改变。OBJECTIVE To explore the correlation betw een brain-derived neurotrophic factor(BDNF) and denervation of soft palate muscle in The direct pathogenesis of obstructive sleep apnea syndrome(OSAS) patients by observing the distribution characteristics and expression level of BDNF in soft palate muscle.METHODS The 45 subjects were divided into mild to moderate OSAS group(15 patients),severe OSAS group(18 patients),control group(12 patients).The morphological and structural characteristics of soft palate muscle were observed under light microscope after HE staining.The distribution characteristics of BDNF in soft palate muscle were observed by immunofluorescence assay.The expression of BDNF in the samples was determined by ELISA.Western blot was used to detect the expression of high molecular weight neurofilament protein(NFH) in samples.RESULTS In the severe OSAS group,the muscle fibers of the soft palate muscle were disordered,and some showed changes after denervation.Compared with the mild-to-moderate OSAS group and the control group,the distribution of BDNF in the soft palate muscle of the severe OSAS group was more disordered.The expression level of BDNF in soft palate muscle of severe OSAS group was significantly higher than that of control group(P=0.001).The NFH expression level of soft palate muscle in mild-to-moderate OSAS group was lower than that in control group(P=0.022).The expression level of BDNF was positively correlated with apnea-hypopnea index(AHI)(r=0.417,P=0.016),but NFH was not.CONCLUSIONBDNF plays an important role in the denervation of soft palate muscle in OSAS patients.The increased expression of BDNF may aggravate the morphological and structural changes of soft palate muscle in OSAS patients.

关 键 词：睡眠呼吸暂停综合征 脑源性神经营养因子 失神经改变 肌肉 神经丝蛋白 

分 类 号：R740[医药卫生—神经病学与精神病学]