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阻塞性睡眠呼吸暂停低通气综合征及打鼾者的颏舌肌和腭垂肌特征

Characteristics of the genioglossus and musculus uvulae in sleep apnea hypopnea syndrome and in snorers.

作者信息

Sériès F J, Simoneau S A, St Pierre S, Marc I

机构信息

Unité de Recherche, Centre de Pneumologie de l'Hôpital Laval, Université Laval, Québec, Canada.

出版信息

Am J Respir Crit Care Med. 1996 Jun;153(6 Pt 1):1870-4. doi: 10.1164/ajrccm.153.6.8665048.

Abstract

Genioglossus (GG) activity has been extensively studied by electromyographic recordings in the investigation of the pathophysiology of sleep apnea-hypopnea syndrome (SAHS). However, the effective force developed by this upper airway (UA) dilator muscle depends on its metabolic and histochemical characteristics. The aim of this study was to compare the metabolic and fiber type characteristics of two UA dilator muscles, musculus uvulae (MU) and GG, in 17 patients with SAHS and in 11 nonapneic snorers. MU and GG samples were obtained during uvulopalatopharyngoplasty. Anthropomorphic characteristics were similar in snorers and patients with SAHS, who differed only in the presence of sleep-related breathing abnormalities. MU glycolytic, glycogenolytic, and anaerobic enzyme activities were significantly greater in patients with SAHS than in snorers. These differences were not observed for GG. MU and GG enzyme activities differed only in snorers. The proportion of type I muscle fiber was greater in GG than in MU, but it was similar in patients with SAHS and snorers for each muscle. Type IIA and IIB muscle fibers were, respectively, in greater and smaller proportions in patients with SAHS than in snorers. We conclude that (1) the differences in metabolic characteristics between patients with SAHS and snorers are not observed in all UA muscles, and (2) similar histochemical differences are observed in GG and MU between these two groups, thus suggesting that these differences may be implicated in the pathophysiology of SAHS.

摘要

在睡眠呼吸暂停低通气综合征(SAHS)病理生理学研究中,已通过肌电图记录对颏舌肌(GG)活动进行了广泛研究。然而,这条上气道(UA)扩张肌产生的有效力量取决于其代谢和组织化学特征。本研究旨在比较17例SAHS患者和11例非呼吸暂停打鼾者的两块UA扩张肌——腭垂肌(MU)和GG的代谢及纤维类型特征。MU和GG样本在悬雍垂腭咽成形术期间获取。打鼾者和SAHS患者的人体测量学特征相似,仅在与睡眠相关的呼吸异常情况方面存在差异。SAHS患者的MU糖酵解、糖原分解和无氧酶活性显著高于打鼾者。GG未观察到这些差异。MU和GG的酶活性仅在打鼾者中有所不同。GG中I型肌纤维的比例高于MU,但SAHS患者和打鼾者的每块肌肉中该比例相似。SAHS患者中IIA和IIB型肌纤维的比例分别高于和低于打鼾者。我们得出结论:(1)并非在所有UA肌肉中都观察到SAHS患者和打鼾者之间代谢特征的差异;(2)在这两组患者的GG和MU中观察到了相似的组织化学差异,因此表明这些差异可能与SAHS的病理生理学有关。

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