CO2气腹对肝硬变大鼠肠黏膜通透性影响的实验研究

目的 探讨CO2气腹对肝硬变大鼠肠道黏膜通透性的影响。方法建立肝硬变大鼠模型。50只大鼠随机分为对照组（n=5），肝硬变组（n=5）及肝硬变气腹组（n=40），肝硬变气腹组根据不同气腹压又分为8mmHg和13mmHg2个亚组，每组20只。各组大鼠（肝硬变气腹组分别在气腹结束后0．5、2、6及12h）取门静脉血检测血清内毒素及D-乳酸含量。结果肝硬变组血清内毒素及D-乳酸含量均明显高于对照组（P〈0．05）；而肝硬变气腹组不同气腹压及持续不同时间后的血清D-乳酸及内毒素含量则均明显高于肝硬变组（P〈0．05），其中血清内毒素含量随气腹压增高而增高（13mmHg vs 8mmHg，F=5．466，P〈0．05），但血清D-乳酸含量不同气腹压间的差异无统计学意义（F=0．415，P〉0．05）。结论肝硬变大鼠肠黏膜通透性增加，在此基础上建立CO2气腹若增加到一定压力并持续一定时间后，可增加肠黏膜的通透性，且此变化随气腹压力增高而加大，但解除气腹后可逐渐恢复。

Experimental Study of Influence of CO2 Pneumoperitoneum on Intestinal Mucosa Permeability in Rats with Liver Cirrhosis

Objective To investigate the influence of CO_2 pneumoperitoneum on intestinal mucosa permeability in rats with liver cirrhosis.Methods Fifty rats were randomly divided into following groups: control group(n=5),cirrhosis group(n=5) and pneumoperitoneum group(n=40);the pneumoperitoneum group was further divided into 8 mm Hg group(n=20) and 13 mm Hg group(n=20).Four time points were chosen,including 0.5,2,6,and 12 hours after the end of pneumoperitoneum.After rat models with cirrhosis were established successfully,the abdominal cavity was insufflated with CO_2 and maintained under the pressures of 8 mm Hg and 13 mm Hg respectively for two hours.The portal venous blood was collected and the levels of D-lactic acid and endotoxin were measured.Results The levels of endotoxin and D-lactic acid in cirrhosis group were much higher than those of control group(P<0.05).The levels of serum endotoxin and D-lactic acid in pneumoperitoneum group were higher than those of cirrhosis group(P<(0.05)) regardless of pressure and time point.The endotoxin level in 13 mm Hg group was higher than that of 8 mm Hg group on different time points(F=5.466,P<0.05),but there was no difference in D-lactic acid level between both of them(F=0.415,P>0.05).Conclusion The intestinal mucosa permeability is increased in rats with liver cirrhosis.It can be further increased under CO_2 pneumoperitoneum with certain pressure and time and in a pressure-dependent manner.The permeability can decrease after removal of pneumoperitoneum.