腹腔感染合并腹腔间隙综合征对肝功能损伤的实验研究

Experimental study of liver injury in rats of abdominal infection with abdominal compartment syndrome

目的评价大鼠腹腔感染合并腹腔间隙综合征（ACS）时肝脏损害的情况。方法sD大鼠分为假手术组、腹腔感染组（盲肠结扎加穿孔）、ACS组和联合组（腹腔感染加ACS）。分别于术后1、6、12和24h分别处死各组动物（每个时间点6只）。检测肝功能指标谷丙转氨酶（ALT）和谷草转氨酶（AST），采用肝脏损伤严重度评分（HISS）来评价肝脏损伤程度；同时使用RT—PCR法检测肝脏组织中的TLR4、TNF-α和IL-6水平。结果术后24h，假手术组、腹腔感染组、ACS组和联合组ALT分别为（18．2±1．3）、（68．2±17．5）、（305．2±128．2）、（409．2±67．1）U／L，AST分别为（105．6±25．5）、（184．6±36．1）、（638．0±104．8）、（743．2±250．2）U／L；其中假手术组均显著低于其他3组，联合组显著均高于腹腔感染组和ACS组（均P〈0．05）。术后24h，腹腔感染组、ACS组和联合组HISS评分分别为5．0、5．5和7．0，显著高于假手术组的1．5，但该3组间的差异则无统计学意义（P〉0．05）。腹腔感染组、ACS组和联合组术后肝脏组织TLR4、TNF-α和IL-6水平均有不同程度的上升，其中以联合组的上升幅度最为显著（P〈0．05）。结论ACS和腹腔感染均可损害肝脏功能，两者联合时肝功能的损害更为显著。

Objective To evaluate the liver injury in rats of abdominal infection complicated with abdominal compartment syndrome （ACS）. Methods SD rats were divided into four groups, including the sham group, the abdominal infection group, the ACS group, and the abdominal infection plus ACS group （combination group）. Rats were sacrificed at 1 h, 6 h, 12 h, 24 h after operation with 6 rats at each time point. Blood specimens were collected for liver function testing. Liver tissues were assessed by pathologically examination with hepatic injury severity scoring （HISS）. The expressions of Toll-like receptor 4 （TLR4）, TNF-α and IL-6 were examined by reverse transcription- polymerase chain reaction. Results At 24h after operation, as compared to the sham group （18.2±1.3） U/L and （105.6±25.5） U/L, ALT and AST increased obviously in the abdominal infection group （68.2± 17.5） U/L and （184.6±36.1） U/L, the ACS group （305.2±128.2） U/L and （638.0±104.8） U/L and the combination group （409.2±67.1） U/L and （743.2±250.2） U/L, while the combination group had a higher level as compared to the infection group and the ACS group （all P〈0.05）. HISS scores were significantly higher in the abdominal infection group（5.0）, the ACS group（5.5 ） and the combination group（7.0） as compared to the sham group（1.5）, but no significant differences were found among the three groups at 24 h after operation. Expressions of TLR4, TNF-α and IL-6 were significantly higher in combination group than those in the other three groups. Conclusions Liver function can be affected by abdominal infection and ACS. Abdominal infection plus ACS results in more severe liver injury.