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目的研究在低压缺氧环境建立阻塞性睡眠呼吸暂停综合征兔模型的方法及模型病理生理的变化。方法将成年日本大白兔12只用随机数字表法分为对照组和实验组(每组6只),实验组置于海拔5 000 m动物低压低氧舱内饲养,每天10 h,连续4周。对照组动物正常对照饲养。对2组动物分别进行上气道CT扫描、动脉血气分析及睡眠呼吸气流监测、咽壁组织及颏舌肌病理学检查。结果①在舌骨水平CT扫描结果:实验组较对照组的咽后壁明显增厚(P<0.01)、前后径明显减小(P<0.05)、截面积明显减小(P<0.01);在软腭中点水平CT扫描结果:实验组较对照组软腭明显增厚(P<0.05),上下径明显减小(P<0.05)。②实验组较对照组睡眠期间的呼吸暂停低通气指数(apnea hypop-nea index,AHI)明显升高(P<0.01)、呼吸频率明显加快(P<0.01)、呼吸时比明显增加(P<0.01)、平均呼吸深度明显增加(P<0.05)。③实验组较对照组动脉血氧分压[p(O2)]明显降低(P<0.01)、二氧化碳分压[p(CO2)]明显增高(P<0.01)。④病理组织学显示:对照组咽后壁黏膜上皮组织为复层扁平上皮,黏膜下层腺体较少;颏舌肌肌纤维排列紧密。实验组咽壁黏膜上皮组织增厚并角化,黏膜下层组织腺体增生;颏舌肌肌纤维萎缩、有溶解断裂现象。结论低压缺氧方法可以成功建立阻塞性睡眠呼吸暂停综合征兔模型,其病理生理改变与阻塞性睡眠呼吸暂停综合征患者表现相似。
Objective To study the method of establishing a rabbit model of obstructive sleep apnea syndrome (HAPI) in hypobaric hypoxia environment and the changes of the pathophysiology of the model. Methods Twelve adult Japanese white rabbits were randomly divided into control group and experimental group (6 in each group) by random number table. The experimental group was housed in hypoxia chamber at 5 000 m altitude for 10 h daily for 4 weeks . The control animals were fed with normal control. The animals in the two groups were subjected to upper airway CT scan, arterial blood gas analysis and monitoring of sleep respiratory flow, pharyngeal wall tissue and genioglossus pathology. Results ① In the hyoid bone level CT scan, the posterior pharyngeal wall of the experimental group was significantly thicker than that of the control group (P <0.01), the anteroposterior diameter was significantly reduced (P <0.05), and the cross - sectional area was significantly reduced (P <0.01). In the soft palate midpoint horizontal CT scan results: the experimental group than the control group soft palate was significantly thicker (P <0.05), the diameter was significantly reduced (P <0.05). ② Compared with the control group, the apnea hypopnea index (AHI) in the experimental group was significantly increased (P <0.01), the respiratory rate was significantly increased (P <0.01) and the respiratory rate was significantly increased (P < 0.01), the average depth of breathing increased significantly (P <0.05). ③ Compared with the control group, the partial pressure of arterial oxygen (p (O2)) in the experimental group decreased significantly (P <0.01) and the partial pressure of carbon dioxide (p CO2) increased significantly (P <0.01). ④ Histopathology showed that mucosal epithelium in the control group posterior pharyngeal mucosa flat epithelium, less submucosal glands; genioglossus muscle fibers arranged closely. The throat mucosa epithelium in the experimental group was thickened and keratinized, the glandular tissue in the submucosa hyperplasia, and the genioglossus myofibrillar atrophy with dissolution and rupture. Conclusion Hypobaric hypoxia can successfully establish a rabbit model of obstructive sleep apnea syndrome, and its pathophysiological changes are similar to those of patients with obstructive sleep apnea syndrome.