CO_2气腹对家兔糖代谢的影响

Effects of CO_2 pneumoperitoneum on glycometabolism in rabbits

目的:观察不同压力CO2气腹对家兔糖代谢的影响。方法:健康家兔20只,随机分为4组,每组5只,分别给予1h不同压力的CO2气腹:对照组0mmHg、A组10mmHg、B组15mmHg、C组20mmHg。于气腹前、气腹30min、60min、4h、24h采集股静脉血,测定血糖、胰岛素、C-肽、乳酸。结果:CO2气腹后各组血糖均升高,气腹压力越大,血糖升高的速度越快,峰值越高。对照组、A组胰岛素和C-肽气腹前后无明显变化,B、C组较气腹前明显升高;各组乳酸浓度无明显变化;CO2气腹后胰岛素敏感指数(ISI)在B、C组明显降低,且气腹压力越高,ISI降低越明显。结论:结果表明CO2气腹可引起血糖、胰岛素升高,胰岛素敏感性降低,产生胰岛素抵抗(IR),且程度与CO2气腹压力有关。

Objective： To observe the effects of CO2 pneumoperitoneum on glycometabolism in rabbits. Methods： 20 healthy rabbits were divided randomly into four groups and each group had five rabbits. COX pneumoperitoneum at different pressure was established for 1 h. The pressure of CO2 pneumoperitoneum was 0 mmHg in the control group, 10 mmHg in group A, 15 mmHg in group B, 20 mmHg in group C. The levels of plasma glucose, insulin, C - peptide, lactic acid were measured before and in 30 min, 1 h, 4 h and 24 h after the pneumoperitoneum. Results：The level of plasma glucose in each group increased markedly after CO2 pneumoperitoneum. The higher the pressure of CO2 pneumoperitoneum was, the faster and the higher the plasma glucose concentration peak reached. The concentration of insulin and C - peptide increased markedly in group B and group C after CO2 pneumoperitoneum, but did not in the control group and group A. there was not any difference of lactic acid among all groups. After CO2 pneumoperitoneum, insulin sensitivity index（ISI） decreased significantly in group B and group C and the higher the pressure of CO2 pneumoperitoneum was, the lower it was. Conclusion： It is indicated that CO2 pneumoperitoneum can induce the development of insulin resistance with impaired insulin sensitivity, in combination with the elevation of plasma glucose and insulin level. The degree of insulin resistance is related with the pressure of CO2 pneumoperitoneum.