口腔矫治器治疗阻塞性睡眠呼吸暂停低通气综合征对雄性新西兰兔生殖系统的影响

Effect of oral appliance on reproductive system of the male New-Zealand rabbit with obstructive sleep apnea-hypopnea syndrome

目的观察下颌前移矫治器治疗阻塞性睡眠呼吸暂停低通气综合征（OSAHS）对雄兔生殖系统的影响。方法将30只纯种雄性6月龄新西兰兔随机分为3组，每组10只，分别为OSAHS组、佩戴矫治器（MAD）组和对照组。在建立OSAHS动物模型基础上，MAD组同时佩戴下颌前移矫治器导下颌向前；对照组不做任何处理，正常饲养。三组动物仰卧位睡眠4～6 h/d，持续8周后，全麻下取材备光镜、电镜下观察，并对精子计数，进行精子活动率、存活率及畸形率的检测。结果与对照组相比，OSAHS组上气道间隙减小，血氧饱和度、氧分压和pH值下降，二氧化碳分压升高，精子计数、活动率、存活率下降，精子畸形率升高，差异均有统计学意义（均P〈0.05）；而MAD组与对照组相比，上述各指标差异均无统计学意义（均P〉0.05）。光镜和透射电镜下观察结果显示，与OSAHS组相比，MAD组睾丸生精细胞、生精小管、生精上皮健康改善；血气分析结果显示血氧饱和度与附睾尾中精子畸形率呈负相关（r＝－0.614，P〈0.001）。结论下颌前移矫治器治疗OSAHS，能减缓缺氧对睾丸中生精细胞的损伤，有效提高精子质量，改善生殖系统健康。

ObjectiveTo observe the effect of the mandible advanced device on the reproductive system of the male New-Zealand rabbit with obstructive sleep apnea-hypopnea syndrome （OSAHS）.MethodsThirty male New-Zealand white rabbits were randomly divided into three groups （with 10 rabbits in each group）： sleep apnea-hypopnea syndrome group （group OSAHS）, mandible advanced device group （group MAD） and control group. On the basis of the OSAHS animal model, mandible advanced devices were used for group MAD animals. After intervention for 8 weeks （sleeping by dorsal position, 4-6 hours/d）, the samples were gained from the animals under general anesthesia and observed under the transmission electron microscope （TEM） and the AX-80 universal microscope. The cauda epididymis was obtained to be observed the number, viability, motility and abnormal rate of spermatozoa.ResultsCompared with the control group, the upper airway space, the saturation of blood oxygen, partial pressure of oxygen, pH, the number, viability rate and motility rate of spermatozoa in cauda epididymis of the group OSAHS were significant decreased （all P〈0.05）, and the partial pressure of carbon dioxide and the rate of teratospermia was significant increased （both P〈0.05）. But compared with the control group, these indexes mentioned above in the group MAD showed no statistical significance （all P〉0.05）. TEM and the light microscope showed that the status of spermatogenic cell, seminiferous tubule and spermatogenic epithelium was improved in the group MAD. The correlation analysis showed that the saturation of blood oxygen had a negative correlation with the rate of teratospermia （r=-0.614, P〈0.001）.ConclusionThe damage of spermatogenic cells and the decrease of the sperm quality caused by OSAHS in New-Zealand rabbits could be improved by the mandible advanced devices.