二氧化碳气腹对正常大鼠肝细胞凋亡影响的实验研究

目的：探讨二氧化碳（CO2）气腹对大鼠肝功能及肝细胞凋亡的影响。方法：用Wistar大鼠，建立不同压力、持续时间不同的CO2气膜，于术前、术后检测肝功能，应用TUNEL法动态检测肝细胞凋亡情况。结果：气腹压力越高，持续时间越长，ALT、AST越高，除低气压组外其余各组术后显著高于术前及假气腹组（P＜0．05）；HE染色观察显示气腹压力越高，持续时间越长，肝组织损害越重；气腹压力越高，持续时间越长，肝细胞凋亡指数（AI）越高；凋亡指数（AI）与肝功能AST和ALT有显著的正相关性（r值分别为0.883、0.892、0.894、0.896、0.901和0．884、0．886、0．889、0．884、0．891，P＜0．01）。结论：CO2气腹引起肝缺血再灌注促肝实质细胞凋亡可能是气腹导致肝功能损害的机制之一。

EFFECTS OF CO2 PNEUMOPERITONEUM ON APOPTOSIS OF HEPATOCELLULAR IN RATS

Objective:To investigate the effects of CO 2 pneumoperitoneum on liver function and apoptosis of hepatocellular in rats. Method:CO 2 pneumoperitoneum of different pressures and durations established by closed methods. The cardio blood sample was taken to analyze liver function. The histological changes of the liver were observed by HE staining and immunohistochemistry. Apoptosis was detected by terminal-deoxynucleotidyl transferase mediated dUTP nick labeling (TUNEL). All blood samples and liver tissue were taken preoperatively and 0h, 4h ,12h ,24h ,72h, 120h after the operation.Results:The higher the pressure and the longer the duration of pneumoperitoneum, the higher the levels of ALT, AST.The higher the pressue and the longer the duration of pneumoperitoneum,the more severity of the hepatic tissue.The positive cells of apoptosis by TUNEL were more significant in rats with higher pressure and longer duration of pneumoperatoneum.Changes of AI was positive correlated to the level of AST and ALT . Conclusion:Ischemic-reperfusion injury promoting the hepatocellular apoptosis might play an important role in causing damage to liver function in rats after CO 2 pneumoperitoneum.