气腹对肝硬化大鼠肠黏膜屏障功能的影响  

Influence of CO_2 pneumoperitoneum on intestinal mucosa barrier in cirrhotic rats

作　　者：闫宏宪[1] 罗丁[2] 陈训如[2] 毛静熙[2] 周正东[2] 余少明[2] 

机构地区：[1]昆明市第一人民医院肝胆外科,昆明650011 [2]成都军区昆明总医院肝胆外科,昆明650032

出　　处：《第三军医大学学报》2007年第4期332-334,共3页Journal of Third Military Medical University

基　　金：成都军区科研基金(01A015)~~

摘　　要：目的研究CO2气腹对肝硬化大鼠肠道黏膜屏障功能的影响。方法采用腹腔多次注射硫代乙酰胺建立肝硬化大鼠模型,设正常对照组(A组),实验对照组(B组),8mmHg气腹组(C组)和13mmHg气腹组(D组),气腹作用时间2h,分别于气腹结束后0.5、2、6、12h4个时间点,测定各组及各时间点门静脉血内毒素、D-乳酸水平、回肠黏膜厚度及绒毛高度值。结果B组与A组相比,内毒素、D-乳酸水平、回肠黏膜厚度及绒毛高度值均存在统计学意义(P<0.05);C、D2组各时点与B组相比各项指标均有统计学意义(P<0.05);C组与D组相比:内毒素(P<0.05)、黏膜厚度(P<0.01)和绒毛高度(P<0.01)均存在统计学意义。结论在本实验条件下,CO2气腹加重了肝硬化大鼠已有的肠黏膜屏障障碍,且此种变化有随气腹压力增高而加大的趋势,但在解除气腹后6、12h已有恢复趋势。Objective To investigate the changes and mechanisms of intestinal mucosa barrier induced by CO2 pneumoperitoneum in cirrhotic rats. Methods Fifty rats were randomized into four groups： normal control group （Group A）, experimental control group （Group B, Veress needle inserted only） and two pneumoperitoneum groups. In pneumoperitoneum groups the abdominal cavity of these rats were insufflated with CO2 and maintained at the pressure of 8 mmHg （Group C） and 13 mmHg （Group D） respectively for 2 h. In condition of sterilization, the portal venous blood was collected and D-lactic acid and endotoxin were measured. The structure of intestinal mucosa was observed. Results All indexes were markedly different （P 〈 0. 05 ） between Groups A and B. All values at different time points and pneumoperitoneum pressure were markedly different in Groups C and D in comparison with Group B （ P 〈 0. 05 ）. The endotoxin level （ P 〈 0. 05 ）, the thickness of mucous membrane（P 〈 0. 05 ） and the height of intestinal villus （ P 〈 0. 01 ） were obviously different between Groups C and D. Conclusion Rats with cirrhosis are vulnerable to the damage of intestinal mucosa barrier under the condition of CO2 pneumoperitoneum.

关 键 词：气腹 肝硬化 内毒素 D-乳酸 肠黏膜屏障 

分 类 号：R333.3[医药卫生—人体生理学] R656[医药卫生—基础医学]