二氧化碳气腹对肝硬变大鼠肝功能影响的实验研究

Effects of CO_2 pneumoperitoneum on liver function in cirrhotic rats

目的探讨二氧化碳(CO_2)气腹对肝硬变大鼠肝功能的影响及可能机制。方法制作大鼠肝硬变模型,建立不同压力、不同持续时间气腹,于术前、术后检测肝功能、内毒素、丙二醛(MDA)、超氧化物歧化酶(SOD)、一氧化氮(NO)、一氧化氮合酶(NOS)含量。HE 及免疫组化观察肝组织学变化。结果 (1)气腹压力越高、持续时间越长丙氨酸转氨酶(ALT)、门冬氨酸转氨酶(AST)、内毒素、MDA、NO、NOS 则越高,术后组显著高于术前及假气腹组(P<0.05);白蛋白(ALB)在第7天有下降趋势,但无显著差异。(2)NO、NOS、ALT、AST 的变化与内毒素变化成正相关(r=0.56、0.57、0.41、0.44,P<0.05)。(3)HE 及免疫组化显示气腹压力越高、持续时间越长诱生型一氧化氮合酶(iNOS)表达越多,肝组织损害越重。结论肝硬变条件下,CO_2气腹对肝功能的损害与内毒素、NO 的异常升高有关。

Objective To investigate the effects of CO_2 pneumoperitoneum on liver function of cirrhotic rats.Methods Rat model of cirrhosis was replicated and CO_2 pneumoperitoneum of different pressures and dura- tions established by closed methods.The venous blood sample was taken to analyze liver function and portal venous blood sample harvested to determine the content of endotoxin.The liver tissue was taken to analyze the levels of MDA,SOD,NHO and NOS.The histological changes of the liver were observed by HE staining and immunohisto- chemistry.All blood samples and liver tissue were taken preoperatively and 1 day,7 days after the operation.Re- sutls(1)The higher the pressure and the longer the duration of pneumoperitoneum,the higher the levels of ALT,AST,endotoxin,MDA,NO and NOS.The value of ALB was decreased on the 7th day after the operation. (2)Changes in levels of NO,NOS,ALT and AST were positively correlated to those in level of endotoxin(r= 0.56,0.57,0.41,0.44;P<0.05).(3)The expression of iNOS was more significant in rats with higher pres- sure and longer duration of pneumoperitoneum.Condusions The levels of plasma endotoxin,NO and NOS are elevated in the cirrhotic rats after CO_2 pneumoperitoneum and they might play an important role in causing damage to liver function.