下颌前移装置治疗阻塞性睡眠呼吸暂停低通气综合征增加一氧化氮释放并改善兔肺动脉高压。

Treatment of Obstructive Sleep Apnea-Hypopnea Syndrome With a Mandible Advanced Device Increases Nitric Oxide Release and Ameliorates Pulmonary Hypertension in Rabbits.

机构信息

Assistant Professor, Department of Orthodontics, College of Stomatology, Hebei Medical University, Shijiazhuang, Hebei, P.R. of China; The Key Laboratory of Stomatology, Shijiazhuang, Hebei, P.R. of China.

Professor, Department of Physiology, Hebei Medical University, Shijiazhuang, Hebei, P.R. of China; Hebei Key Laboratory of Vascular Homeostasis and Hebei Collaborative Innovation Center for Cardio-Cerebrovascular Disease, Shijiazhuang, Hebei, P.R. of China.

出版信息

J Oral Maxillofac Surg. 2021 Mar;79(3):694.e1-694.e12. doi: 10.1016/j.joms.2020.09.043. Epub 2020 Oct 8.

DOI:10.1016/j.joms.2020.09.043

PMID:33259783

Abstract

PURPOSE

To investigate the effects of mandible advanced device (MAD) therapy for obstructive sleep apnea-hypopnea syndrome (OSAHS) on nitric oxide (NO) release and changes in pulmonary artery pressure and structure.

METHODS

Thirty male New Zealand white rabbits were randomly divided into OSAHS, MAD, and control groups (n = 10 per group). The soft palate of rabbits in the OSAHS and MAD groups was injected with hydrophilic polyacrylamide gel to induce OSAHS. The MAD group wore a MAD, and the control group was not treated. Cone-beam computed tomography scans and polysomnography recordings were performed to confirm successful model establishment. All rabbits slept in a supine position for 4 to 6 hours daily and were observed for 8 consecutive weeks. The pulmonary artery pressure was measured by right heart catheterization. Pulmonary artery morphometry was analyzed by hematoxylin and eosin staining. NO levels in plasma and lung homogenate supernatants were detected by Griess reaction assay kits.

RESULTS

The OSAHS group exhibited higher pulmonary artery pressure (57.74 ± 1.79 mm Hg) than the MAD (19.99 ± 2.04 mm Hg) and control (14.49 ± 0.54 mm Hg) groups. The media thickness percentage of the pulmonary artery was higher in the OSAHS group (46.89 ± 2.72%) than the control group (15.87 ± 1.18%) and was markedly reduced by MAD (21.64 ± 1.45%). Blood oxygen saturation was positively correlated with the NO concentration in both the lung and plasma, and the NO concentration was negatively correlated with the media thickness percentage and media section percentage.

CONCLUSIONS

OSAHS induced a decrease in NO and pulmonary hypertension, which was relieved by MAD therapy.

摘要

目的

探讨下颌前移装置（MAD）治疗阻塞性睡眠呼吸暂停低通气综合征（OSAHS）对一氧化氮（NO）释放及肺动脉压和结构改变的影响。

方法

30 只雄性新西兰白兔随机分为 OSAHS 组、MAD 组和对照组（每组 10 只）。OSAHS 组和 MAD 组兔软腭注射亲水性聚丙烯酰胺凝胶诱导 OSAHS，MAD 组佩戴 MAD，对照组不做处理。通过锥形束计算机断层扫描和多导睡眠图记录确认模型建立成功。所有兔子每天仰卧睡眠 4 至 6 小时，连续观察 8 周。右心导管测量肺动脉压。苏木精-伊红染色分析肺动脉形态计量学。用硝酸还原酶法检测血浆和肺匀浆上清液中 NO 水平。

结果

OSAHS 组肺动脉压（57.74±1.79mmHg）高于 MAD 组（19.99±2.04mmHg）和对照组（14.49±0.54mmHg）。OSAHS 组肺动脉中层厚度百分比（46.89±2.72%）高于对照组（15.87±1.18%），MAD 治疗明显降低（21.64±1.45%）。血氧饱和度与肺和血浆中的 NO 浓度呈正相关，NO 浓度与中层厚度百分比和中层面积百分比呈负相关。