目的:观察持续气道正压通气(CPAP)对阻塞性睡眠呼吸暂停综合征(OSAS)小型猪血清NO、血浆ET浓度及心肌组织结构的影响。方法:24只雄性成年中国小型猪随机分为正常对照组、OSAS模型组、CPAP治疗组及阳性对照组共4组(n=6)。后3组均给予22d、6h/d的间歇性低压低氧处理制备OSAS模型,CPAP治疗组给予连续30d、6h/d的CPAP治疗,阳性对照组制模成功后继续饲养30d后与CPAP治疗组同时处死,正常对照组与OSAS模型组同时处死。各组处死前均行睡眠监测和血浆ET、血清NO浓度测定,死后取心肌组织行病理学检查。结果:CPAP治疗组较OSAS模型组、阳性对照组低通气指数(AHI)显著降低(P〈0.05)、血氧饱和度(SpO2)显著上升(P〈0.05);较正常对照组AHI显著增高(P〈0.05),SpO2无统计学差异。正常对照组、OSAS模型组、CPAP治疗组及阳性对照组猪血清NO浓度(μmol/L)分别为:0.221±0.062、0.110±0.033、0.115±0.061、0.077±0.043,血浆ET浓度(pg/ml)分别为:40.2±4.8、99.8±22.4、67.1±18.5、103.7±30.1。CPAP治疗组较阳性对照组NO浓度上升、ET浓度下降,较模型组ET浓度下降(P均〈0.05)。心肌组织病理:模型组、CPAP治疗组、阳性对照组心肌组织较正常对照组均发生低氧缺血损害;CPAP治疗组心肌组织病变程度较模型组、阳性对照组轻,较正常对照组重。结论:30d的CPAP治疗可以改善OSAS小型猪睡眠监测指标,血浆ET、血清NO浓度,及心肌组织的病变。
Objective:To investigate the effect of continuous positive airway pressure (CPAP) on serum NO and plasma ET and myocardial structure in mini pigs with obstructive sleep apnea syndrome (OSAS). Methods: Twenty-four male mini pigs were evenly randomized into 4 groups: normal control group (group A), OSAS model group (group B), CPAP treated group (group C) and positive control group (group D). Animals in group A were not treated and those in the other 3 groups were treated with intermittent hypobaric hypoxia 6 h daily for 22 d. Animals in groups C was also given further CPAP treatment 6 h daily for 30 d. The animals in group D were raised for 30 d and were sacrificed together with those in group C; the animals in group A and group B were sacrificed simultaneously. Sleep monitoring and determination of serum NO and plasma ET were performed before execution and pathological examination of myocardial structure after execution. Results: The apnea-hypopnea index (AHI) of group C was significantly lower than those of group B and D and higher than that of group A (P〈0.05); the SpO2 of group C was significantly higher than those of group B and D (P〈0.05), and was similar to that of group A. The levels of NO in group A, B, C, and D were (0. 221±0. 062), (0. 115±0. 061), (0. 110±0. 033), (0. 077±0. 043) μmol/L, respectively, and the levels of ET were (40.2±4.8), (99.8±22.4), (67. 1±18.5), and (103.7±30.1) pg/ml, respectively. Group C had significantly higher NO level and lower ET level compared with group D (P〈0.05). The ET level in group C was significantly lower than that in group B (P〈0. 05). Pathological examination showed that the myocardial structure in group B,C, and D all had hypoxia and ischemia damage compared with group A; the damage in group C was slighter than that in group B and D, but severer than that in group A. Conclusion: Thirty day-treatment with CPAP can improve the sleeping indices, plasma ET and serum N