二氧化碳气腹中不同腹内压对肝线粒体的影响  

Effects of different intra-abdominal pressures on hepatic mitochondria during carbon dioxide pneumoperitoneum in rabbits

作　　者：李军[1] 孙小琴[1] 刘英海[1] 叶占勇[1] 汪海洋[1] 刘合年[1] 

机构地区：[1]成都军区总医院麻醉科,成都610083

出　　处：《西南国防医药》2011年第3期236-238,共3页Medical Journal of National Defending Forces in Southwest China

基　　金：成都军区医学科研"十一五"计划课题(MB07011)

摘　　要：目的观察二氧化碳气腹中不同腹内压对肝细胞线粒体的影响。方法 18只雄性健康家兔,根据二氧化碳气腹的腹内压随机分为3组:对照组(0 mmHg)、10 mmHg组、15 mmHg组,每组6只。每只家兔均接受相应腹内压的气腹1 h。气腹后12 h取肝组织在透射电镜下观察,分离并测定肝细胞线粒体腺苷酸转位酶(ANT)的密度及活性。结果透射电子显微镜下可见10 mmHg组的肝细胞线粒体轻度肿胀,而15 mmHg组的线粒体肿胀更明显,且部分内嵴消失。无论是10 mmHg组还是15 mmHg组,肝细胞线粒体ANT的密度与对照组相比无显著变化;10 mmHg组ANT活性与对照组相比无显著变化,但15 mmHg组较其他两组ANT活性显著下降(P<0.01)。结论 10 mmHg和15 mmHg的腹内压均可导致肝细胞线粒体损害,但15 mmHg损伤更重,腹腔镜手术应尽可能采用低气腹压。Objective To observe the effects of different intra-abdominal pressures on hepatic mitochondria during carbon dioxide pneumoperitoneum in rabbits.Methods According to the intra-abdominal pressure of carbon dioxide pneumoperitoneum,18 healthy male rabbits weighing 3.0-3.5 kg were randomly divided into 3 groups（n=6）：control group（0 mmHg）,10 mmHg group and 15 mmHg group.Each rabbit was subjected to corresponding intra-abdominal pressure for 1 h.12 h after carbon dioxide pneumoperitoneum,the pathological changes of hepatic mitochondria were observed under transmission electron microscope.The density and activity of adenine nucleotide translocase（ANT）in isolated hepatic mitochondria were detected by inhibitor titration and termination technique,respectively.Results The hepatic mitochondria were slightly swelled in 10 mmHg group,and severely swollen mitochondria with partial cristae being broken and disappeared were observed under transmission electron microscope in 15 mmHg group.There were no differences in the density of mitochondrial ANT among three groups.The activity of ANT had no significant difference between control group and 10 mmHg group,but it was obviously lower in 15 mmHg group than that in the other two groups（P0.01）.Conclusion The carbon dioxide pneumoperitoneum whether 10 mmHg or 15 mmHg intra-abdominal pressures can result in hepatic mitochondria injury,but it is severer under 15 mmHg.Therefore,low pressure should be adopted during the laparoscopic operation as far as possible.

关 键 词：二氧化碳气腹 腹内压 线粒体 腺苷酸转位酶 

分 类 号：R616[医药卫生—外科学]