Oksuz Hafize, Bulbuloglu Ertan, Senoglu Nimet, Ciralik Harun, Yuzbasioglu M Fatih, Kilinc Metin, Dogan Zafer, Goksu Mustafa, Yildiz Huseyin, Ozkan Orhan Veli, Atli Yalcin
Department of Anesthesiology, KSU, Faculty of Medicine, Kahramanmaras, Turkey.
Ren Fail. 2009;31(4):297-302. doi: 10.1080/08860220902780044.
Pneumoperitoneum (P) created to facilitate laparoscopy (L) is associated with splanchnic hypoperfusion, ischemia/reperfusion (I/R) injury, and oxidative stress.
This study investigated the effects of pre- and post-laparoscopic conditioning, zinc, pentoxifylline (PTX), and N-acetylcysteine (NAC) on markers of I/R injury in an animal model.
Sprague-Dawley male rats (n = 56, weight range 300-350 g) were randomly placed in one of seven treatment groups. Except for group C (control group who underwent a sham operation without pneumoperitoneum), pneumoperitoneum was created in all using CO(2) insufflation under a pressure of 15 mmHg. Group L (laparoscopy) was subjected to 60 min of pneumoperitoneum. Group Lpre (laparoscopic preconditioning plus laparoscopy) was subjected to 5 min of insufflation and 5 min of desufflation followed by 60 min of pneumoperitoneum. Group Lpost (laparoscopy plus laparoscopic post-conditioning) was subjected to 60 min of pneumoperitoneum and 60 min of desufflation followed by 5 min of insufflation and 5 min of desufflation. The laparoscopy plus zinc (LZ), PTX (LP), and NAC (LNAC) groups received a single intraperitoneal injection of zinc (50 mg/kg), pentoxifylline (50 mg/kg), or N-acetylcysteine (150 mg/kg) 5 min before the desufflation period. Animals were sacrificed at the end of the experiments, and kidney samples were tested for malondialdehyde (MDA), catalase (CAT), glutathione peroxidase (GPX), and superoxide dismutase (SOD).
MDA levels, as an indicator of oxidative stress in kidney tissue samples, were significantly higher in all pneumoperitoneum groups compared to Group C, except for Group Lpre. The pattern of change in tissue levels of SOD, GPX, and catalase was variable in the different treatment groups.
In this animal model of renal ischemia/reperfusion injury, laparoscopy caused renal ischemia as evidenced by elevated markers of tissue ischemia-reperfusion injury. This effect was significantly attenuated by post-laparoscopy conditioning, zinc, pentoxifylline, and N-acetylcysteine, but not by pre-laparoscopy conditioning.
为便于进行腹腔镜检查（L）而建立的气腹（P）与内脏低灌注、缺血/再灌注（I/R）损伤及氧化应激相关。
本研究在动物模型中探究腹腔镜检查前后预处理、锌、己酮可可碱（PTX）及N-乙酰半胱氨酸（NAC）对I/R损伤标志物的影响。
将56只体重范围为300 - 350 g的雄性Sprague-Dawley大鼠随机分为七个治疗组之一。除C组（接受无气腹假手术的对照组）外，其余各组均采用二氧化碳气腹，压力为15 mmHg。L组（腹腔镜检查组）接受60分钟气腹。Lpre组（腹腔镜预处理加腹腔镜检查）先进行5分钟充气和5分钟放气，然后进行60分钟气腹。Lpost组（腹腔镜检查加腹腔镜后处理）先进行60分钟气腹和60分钟放气，然后进行5分钟充气和5分钟放气。腹腔镜检查加锌（LZ）组、PTX组（LP）和NAC组（LNAC）在放气期前5分钟腹腔注射一次锌（50 mg/kg）、己酮可可碱（50 mg/kg）或N-乙酰半胱氨酸（150 mg/kg）。实验结束时处死动物，检测肾组织样本中的丙二醛（MDA）、过氧化氢酶（CAT）、谷胱甘肽过氧化物酶（GPX）和超氧化物歧化酶（SOD）。
作为肾组织样本氧化应激指标之一的MDA水平，除Lpre组外，所有气腹组均显著高于C组。不同治疗组中SOD、GPX和过氧化氢酶的组织水平变化模式各不相同。
在这个肾缺血/再灌注损伤动物模型中，腹腔镜检查导致了肾缺血，组织缺血再灌注损伤标志物升高证明了这一点。腹腔镜检查后预处理、锌、己酮可可碱和N-乙酰半胱氨酸可显著减轻这种影响，但腹腔镜检查前预处理则无此作用。
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