Xu Gui-Sen, Liu He-Nian, Li Jun, Wu Xiao-Ling, Dai Xue-Mei, Liu Ying-Hai
Department of Anesthesia, General Hospital of Chengdu Military Command Area, Chengdu, Sichuan Province, China.
World J Gastroenterol. 2009 Jun 28;15(24):3060-4. doi: 10.3748/wjg.15.3060.
To observe the hepatic injury induced by carbon dioxide pneumoperitoneum in rats and to explore its potential mechanism.
Thirty healthy male SD rats were randomly divided into control group (n = 10), 0 h experimental group (n = 10) and 1 h experimental group (n = 10) after sham operation with carbon dioxide pneumoperitoneum. Histological changes in liver tissue were observed with hematoxylin-eosin staining. Liver function was assayed with an automatic biochemical analyzer. Concentration of malonyldialdehyde (MDA) and activity of superoxide dismutase (SOD) were assayed by colorimetry. Activity of adenine nucleotide translocator in liver tissue was detected with the atractyloside-inhibitor stop technique. Expression of hypoxia inducible factor-1 (HIF-1) mRNA in liver tissue was detected with in situ hybridization.
Carbon dioxide pneumoperitoneum for 60 min could induce liver injury in rats. Alanine aminotransferase and aspartate aminotransferase were 95.7 +/- 7.8 U/L and 86.8 +/- 6.9 U/L in 0 h experimental group, and 101.4 +/- 9.3 U/L and 106.6 +/- 8.7 U/L in 1 h experimental group. However, no significant difference was found in total billirubin, albumin, and pre-albumin in the three groups. In 0 h experimental group, the concentration of MDA was 9.83 +/- 2.53 micromol/g in liver homogenate and 7.64 +/- 2.19 micromol/g in serum respectively, the activity of SOD was 67.58 +/- 9.75 nu/mg in liver and 64.47 +/- 10.23 nu/mg in serum respectively. In 1 h experimental group, the concentration of MDA was 16.57 +/- 3.45 micromol/g in liver tissue and 12.49 +/- 4.21 micromol/g in serum respectively, the activity of SOD was 54.29 +/- 7.96 nu/mg in liver tissue and 56.31 +/- 9.85 nu/mg in serum, respectively. The activity of ANT in liver tissue was 9.52 +/- 1.56 in control group, 6.37 +/- 1.33 in 0 h experimental group and 7.28 +/- 1.45 (10(-9) mol/min per gram protein) in 1 h experimental group, respectively. The expression of HIF-1 mRNA in liver tissue was not detected in control group, and its optical density difference value was 6.14 +/- 1.03 in 0 h experimental group and 9.51 +/- 1.74 in 1 h experimental group, respectively.
Carbon dioxide pneumoperitoneum during the sham operation can induce hepatic injury in rats. The probable mechanisms of liver injury include anoxia, ischemia reperfusion and oxidative stress. Liver injury should be avoided during clinical laparoscopic operation with carbon dioxide pneumoperitoneum.
观察二氧化碳气腹对大鼠肝脏的损伤,并探讨其潜在机制。
将30只健康雄性SD大鼠随机分为对照组(n = 10)、假手术二氧化碳气腹后0 h实验组(n = 10)和1 h实验组(n = 10)。用苏木精-伊红染色观察肝组织的组织学变化。用自动生化分析仪检测肝功能。用比色法测定丙二醛(MDA)浓度和超氧化物歧化酶(SOD)活性。用苍术苷抑制法检测肝组织中腺嘌呤核苷酸转位酶的活性。用原位杂交检测肝组织中缺氧诱导因子-1(HIF-1)mRNA的表达。
二氧化碳气腹60 min可诱导大鼠肝损伤。0 h实验组丙氨酸氨基转移酶和天冬氨酸氨基转移酶分别为95.7±7.8 U/L和86.8±6.9 U/L,1 h实验组分别为101.4±9.3 U/L和106.6±8.7 U/L。然而,三组总胆红素、白蛋白和前白蛋白差异无统计学意义。0 h实验组肝匀浆中MDA浓度为9.83±2.53 μmol/g,血清中为7.64±2.19 μmol/g,肝组织中SOD活性为67.58±9.75 nu/mg,血清中为64.47±10.23 nu/mg。1 h实验组肝组织中MDA浓度为16.57±3.45 μmol/g,血清中为12.49±4.21 μmol/g,肝组织中SOD活性分别为54.29±7.96 nu/mg和56.31±9.85 nu/mg。对照组肝组织中ANT活性为9.52±1.56,0 h实验组为6.37±1.33,1 h实验组为7.28±1.45(10⁻⁹mol/min每克蛋白)。对照组肝组织未检测到HIF-1 mRNA表达,0 h实验组光密度差值为6.14±1.03,1 h实验组为9.51±1.74。
假手术期间二氧化碳气腹可诱导大鼠肝损伤。肝损伤的可能机制包括缺氧、缺血再灌注和氧化应激。临床二氧化碳气腹腹腔镜手术时应避免肝损伤。