肝、脾联合伤后非气腹状态和气腹状态下对兔谷草转氨酶、谷丙转氨酶、心肌肌钙蛋白T影响

Ecffccts of gasless laparoscopic states and CO2 pneumopedtoneum states on hepatic function and hepatic blood flow to combined liver--spleen wound in rabbits

目的：探讨肝、脾联合伤后在非气腹状态和气腹状态下兔谷苹转氨酶（aspartateaminotransferase，AST）、谷丙转氨酶（alanineaminotrans—ferase，ALT）和心肌肌钙蛋白T（cTnT）的变化，了解非气腹状态下对肝脏和心脏的影响。方法：制作肝、脾联合伤兔模型，用随机数字表将48只兔分为6组。观察伤后0．5h、1h、2．5h、3h4个点谷苹转氨酶（aspartateaminotransferase。AST）、谷丙转氨酶（alanineaminotransferase，ALT）和心肌肌钙蛋白T（cTnT）的变化。结果：非气腹状态下AST和ALT的较创伤前升高（P〈0．05），但和气腹状态相比升高幅度显著减少（P〈0．05）．非气度状态下肝脏表面的血流量降低不显著（P〉0．05），而气腹组显著下降（P〈0．05）．非气腹状态下心肌肌钙蛋白T（cTnT）升高不显著（P〉0．05），气腹状态下仅在严重创伤气腹时间较长时心肌肌钙蛋白T（cTnT）上升显著（P〈0．05）．蛄论：非气腹状态比气腹状态对谷革转氨酶、谷丙转氨醇和心肌肌钙蛋白T的影响更小。

Object To investigate the change of hepatic function（HF） and hepatic blood flow（HBF） under gasless laparoscopic states and CO2 pneumoperitoneum states to combined liver--spleen wound in rabbits. Methods 48 New Zealand rabbits were randomized into 6 groups according to the intra--ab- dominal pressures（IAP）. After achievement of combined liver--spleen wound model, aspartate aminotransferase （AST） , alanine aminotransferase （ALT）, cardic troponin（cTn） were observed at time of wound,0. 5hour after wound,2 hours after wound and 2. 5 hours after wound. Results AST and ALT of the group of CO2 pneumoperitoneum states statistically increased than the group of COz Pneumoperitoneum. And HBFof the group of CO2 pneumo- peritoneum states statistically decreased than the group of gasless laparoscopie states, cardic troponin（cTn） of the group of CO2 Pneumoperitoneum states of II and III liver--spleen wound statistically increased than the group of gasless laparoscopic states. Conclusions The disturbance of the AST and ALT of rabbits the group of gasless laparoscopie states in rabbits is significantly lower than the group of CO2 Pneumoperitoneum. The crease of the cardie troponin （eTn） of rabbits the group of gasless laparoscopic states in rabbits is significantly lower than the group of CO2 Pneumoperitoneum.