| Objectives: To set up the animal model of New-Zealand white rabbits with obstructive sleep apnea-hypopnea Syndrome (OSAHS), and to observe the damage of renal cortex under OSAHS and treated by mandible advanced device (MAD), which provided the theoretical base and laboratory data for treatment of kidney disease caused by OSAHS in clinical patients.Methods: Thirty-three male New-Zealand white rabbits were randomly divided into three groups and 11 rabbits in each. Three groups were obstructive sleep apnea-hypopnea syndrome group(group OSAHS ),mandible advanced device group(group MAD) and control group. A total of 2ml polyacrylamide hydrogel were injected into rabbit soft palate of group OSAHS and group MAD when the animals were snored with intermittent apnea, then the upper airway of rabbits was stenosis and saturation of blood oxygen decreased by 22% comparing with control group, which indicated OSAHS animal model was feasible. Group MAD animals were worn mandible advanced device, and the animals of control group animals did not receive any treatment.The cephalometry of upper airway of three groups by dorsal position were made and measured. One milliliter auricle arterial blood by dorsal position was collected and blood gas analysis was performed, then 10% Chloral Hydrate was perfused by mouth of the animals in three groups by 5-6ml/kg, and slept 4-6 hours by dorsal position was performed every day for 8 weeks.After sleep for 8 weeks by dorsal position, the animals of three groups were anaesthetized with 1% pentobarbital sodium and abdominal cavity were anatomized to expose right kidney, then a small piece of sample of renal cortex which was at the cross of longitudinal axis and lateral axis was obtained, and was put into pre-cool 2.5% glutaraldehyde followed by dealing with transmission electron microscope (TEM) samples and embedding in Epon812, ultrastructure of renal cortex were observed under Hitach-7500 TEM; meanwhile the right kidney was cut at the maximum diameter and was put into 10% formalin followed by paraffin imbedding and HE staining, then tissue of kidney was observed under AX-80 universal microscope. At the same time, the tissue of injection site was obtained, and fixed in 10% formalin to observe histological structure.The statistical analyses for cephalometry, blood gas analysis and blood samples were performed by using the SPSS13.0 statistical program (P<0.05).Results: The cephalometry data of the upper airway space of group OSAHS at 1/4 point, middle point and 1/4 point were significantly decreased comparing with that of group MAD and control group respectively (P<0.05), while the upper airway space of group MAD was more wider than control group with not any significant difference(P>0.05).The result of blood gas analysis show that the saturation of blood oxygen, partial pressure of oxygen and pH of both group OSAHS were more decreased significantly than that of group MAD and control group (P<0.05), the data of partial pressure of carbon dioxide of group OSAHS was more increased significantly than that of group MAD and control group (P<0.05). These above measures had no significant differences between group MAD and control group(P>0.05).Histologic observation of the tissue from the injection site found that hyalo-white jelly which was invested integrally in the soft plate could be seen by naked eye, and the jelly was tenacious and flexible. Under light microscope, connective tissue pellicle comprised elastic and collagen could be seen at the exterior of jelly, and the jelly was cross-link with sharp limitation with circum-tissues.In naked eye, there was no visible change of kidney of the three groups. Observation of the renal cortex under light microscope; and plenty of epithelial cell of renal tubule of renal cortex of group OSAHS were swelling and vacuolar degeneration; capsular space was narrowing or vanished because of intumescent renal glomerulus , meanwhile plentiful cells of renal glomerulus were vacuolization ;and renal interstitium was fibrosis with partial calcification .A small quantity of epithelial cell of renal tubule of renal cortex of group MAD were swelling without vacuolar degeneration ,and capsular space was narrowing with renal glomerulus slight swell, and there was small plenty of renal interstitium among renal tubule and renal glomerulus. The morphous of epithelial cell of renal tubule of renal cortex of control group were cubical or pyramidal and nucleus located at basilar part of cell, and there were no swelling or degeneration; and the shape of renal glomerulus was normal with adqulis capsular space; and fibrosis was not observed in renal interstitium.In naked eye, no visible distension of kidney was found. Ultrastructure of coronary artery: The mitochondria of epithelial cell of proximal convoluted tubule of group OSAHS were swelling with buninoid or elliptic, and some mitochondria were vacuolization; and nuclear chromatin of endothelial cell of renal glomerulus was pycnotic; and foot processes were swelling and fusion. Some mitochondria of epithelial cell of proximal convoluted tubule of group MAD were swelling without vacuolization; and there was slight pyknosis in epithelial cell of renal glomerulus, and small plenty of foot processes were swelling. There were plenty of mitochondria in epithelial cell of proximal convoluted tubule of control group with typical elliptic or clavillose; and distribution of nuclear chromatin of epithelial cell of renal glomerulus was aequalis; and foot processes were palisade arrangement without swelling. Conclusions:The damage of renal tubule, renal glomerulus and interstitium of renal cortex was improved significantly by treated with mandible advanced device. |
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