Hsieh Chih-Sung, Tain You-Lin, Chen Yu-Chieh, Chang Kowaung, Jean Yen-Hsuan, Huang Li-Tung
Department of Pediatric Surgery, Pingtung Christian Hospital, Pingtung, Taiwan.
Pediatr Surg Int. 2011 Mar;27(3):289-94. doi: 10.1007/s00383-010-2801-4. Epub 2010 Nov 26.
The aim of this study was to investigate the effects of carbon dioxide (CO(2)) pneumoperitoneum on the intra-abdominal spread of bacteria, the local and systemic cytokine expression, and oxidant/antioxidant status in young rats with bacterial peritonitis.
Young Sprague-Dawley rats, aging 20-27 days and weighing around 50 g, were allocated to six groups of six to nine animals in each. Intra-abdominal infection model was developed by intraperitoneal injection with 1 cc of Escherichia coli (E. coli) (10(8) CFU/mL, ATCC25922 strain) via right lower abdominal wall. Carbon dioxide (CO(2)) pneumoperitoneum was applied to the rats via umbilical pit insufflation with 20 cc CO(2) for 30 min. All survived rats underwent laparotomy and were killed 24 h or 3 days later. Serum levels of CO(2) and CRP were measured. Left lower abdomen peritoneum, peritoneal fluid, mesenteric lymph node of terminal ileum, and liver were taken for bacterial culture. Liver and plasma levels of TNF-α, IL-1β, and IL-6 were examined for the level of local and systemic immunologic response. Oxidant/antioxidant status in liver and plasma were assessed by measuring malondialdehyde (MDA), and reduced to oxidized glutathione ratio (GSH/GSSG).
Carbon dioxide (CO(2)) pneumoperitoneum does not facilitate E. coli dissemination to other intra-abdominal organs in rats with localized E. coli peritonitis. Peritonitis rats that underwent abdominal CO(2) insufflation have insignificantly higher CRP or lower CO(2) levels. Plasma and liver TNF-α, IL-1β concentrations were not significantly different among the four groups, but plasma IL-6 was significantly increased in rats with E. coli peritonitis and CO(2) pneumoperitoneum that were killed 3 days later as compared with that of rats that were killed 24 h later. In rats with E. coli peritonitis, CO(2) pneumoperitoneum was significantly associated with decreased hepatic GSH/GSSG ratio. However, plasma and liver MDA levels were not altered after CO(2) pneumoperitoneum.
Carbon dioxide (CO(2)) pneumoperitoneum is not associated with E. coli dissemination in the presence of local intra-abdominal infection. CO(2) pneumoperitoneum elicited systemic anti-inflammatory response at a specific time period and decreased hepatic antioxidant status in young rats with E. coli peritonitis.
本研究旨在探讨二氧化碳（CO₂）气腹对细菌性腹膜炎幼鼠腹腔内细菌播散、局部和全身细胞因子表达以及氧化/抗氧化状态的影响。
选用20 - 27日龄、体重约50 g的年轻Sprague-Dawley大鼠，分为6组，每组6 - 9只动物。通过经右下腹壁腹腔注射1 cc大肠杆菌（E. coli）（10⁸ CFU/mL，ATCC25922菌株）建立腹腔感染模型。通过脐部穿刺向大鼠注入20 cc CO₂ 30分钟建立二氧化碳（CO₂）气腹。所有存活的大鼠均接受剖腹手术，并在24小时或3天后处死。检测血清CO₂和CRP水平。取左下腹部腹膜、腹腔液、回肠末端肠系膜淋巴结和肝脏进行细菌培养。检测肝脏和血浆中TNF-α、IL-1β和IL-6水平，以评估局部和全身免疫反应水平。通过测量丙二醛（MDA）以及还原型谷胱甘肽与氧化型谷胱甘肽的比值（GSH/GSSG）评估肝脏和血浆中的氧化/抗氧化状态。
在局限性大肠杆菌性腹膜炎大鼠中，二氧化碳（CO₂）气腹并不促进大肠杆菌向其他腹腔内器官播散。接受腹腔CO₂充气的腹膜炎大鼠CRP水平略高或CO₂水平略低，但差异无统计学意义。四组之间血浆和肝脏TNF-α、IL-1β浓度无显著差异，但与24小时后处死的大鼠相比，3天后处死的大肠杆菌性腹膜炎并接受CO₂气腹的大鼠血浆IL-6显著升高。在大肠杆菌性腹膜炎大鼠中，CO₂气腹与肝脏GSH/GSSG比值降低显著相关。然而，CO₂气腹后血浆和肝脏MDA水平未改变。
在存在局部腹腔感染的情况下，二氧化碳（CO₂）气腹与大肠杆菌播散无关。CO₂气腹在特定时间段引发全身抗炎反应，并降低了大肠杆菌性腹膜炎幼鼠的肝脏抗氧化状态。
