下颌前移矫治器对阻塞性睡眠呼吸暂停兔肾皮质的形态学影响  

Morphological effects of mandibular advancement device on renal cortex in rabbits with obstructive sleep apnea

作　　者：张士珑 肖玮 康文静 刘杰 乔星[1] 卢海燕[1] ZHANG Shilong;XIAO Wei;KANG Wenjing;LIU Jie;QIAO Xing;LU Haiyan(Department of Orthodontics,Hebei Key Laboratory of Stomatology,Hebei Clinical Researchh Center for Oral Diseases,School and Hospital of Stomatology,Hebei Medical Uviversity,Shijiazhuang 050017)

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,石家庄050017

出　　处：《现代口腔医学杂志》2023年第1期1-5,共5页Journal of Modern Stomatology

基　　金：河北省医学科学研究课题(20210144);河北省自然科学基金(H2020206465)。

摘　　要：目的探讨下颌前移矫治器(mandibular advancement device,MAD)治疗阻塞性睡眠呼吸暂停(obstructive sleep apnea,OSA)对兔肾皮质的形态学影响。方法将18只实验动物随机分为三组,分别为OSA组、MAD组、对照组,每组6只。诱导三组动物仰卧位睡眠4~6小时/天,8周后,切取肾皮质观察显微结构及超微结构。结果光镜观察:OSA组肾皮质内的肾小管上皮细胞肿胀、变性;肾小球体积显著增大,大量细胞水肿、空化;肾间质纤维化、局限性钙化。MAD组肾小管上皮细胞偶有肿胀,无变性;肾小球体积略增大;肾间质未见纤维化;对照组未见异常。超微结构观察:OSA组近曲小管上皮细胞线粒体肿胀变性、部分空泡化;肾小球足细胞的核染色质凝聚、碎裂,足突出现肿胀和融合。MAD组近曲小管上皮细胞仅有少量线粒体肿胀;肾小球足细胞的核染色质凝聚较少,少量足突肿胀。对照组未见异常。结论MAD治疗OSA能减缓其对肾皮质的形态学结构损伤。Objective To investigate the morphological effects of mandibular advancement device on renal cortex in rabbits with obstructive sleep apnea.Methods Eighteen experimental animals were randomly divided into three groups:OSA group,MAD group and the control group,with 6 animals in each group.All animals were induced to sleep in supine position for 4~6 hours per day.Renal cortex were taken to observe the microstructures and ultrastructures eight weeks later.Results Observation under a light microscope:in Group OSA,a large number of epithelial cells of renal tubule in renal cortex showed swelling and degeneration;the volume of glomerulus increased markedly and a large number of cells in renal glomerulus were edema and cavitation;fibrosis and localized calcification occurred in renal interstitium.In Group MAD,the renal tubular epithelial cells showed occasional swelling and no degeneration;the volume of glomerulus increased slightly and there was no fibrosis in renal interstitium.No abnormal changes were observed in the control group.Ultrastructures of renal cortex:in Group OSA,mitochondria in proximal convoluted tubular epithelial cells showed swellingdegeneration and partial vacuolization;condensation and fragmentation of nuclear chromatin could be seen in podocytes and swelling and fusion occurred in foot processes.In Group MAD,there was only a small amount of mitochondrial swelling in proximal convoluted tubular epithelial cells;less nuclear chromatin condensation could be seen in podocytes and a small number of foot processes were swelling.No abnormal changes were observed in the control group.Conclusion Treating OSA with MAD can slow down its damage to the morphological structure of renal cortex.

关 键 词：下颌前移矫治器 阻塞性睡眠呼吸暂停 肾皮质 透射电镜 光镜 

分 类 号：R783.5[医药卫生—口腔医学]