异丙酚预处理对二氧化碳气腹家兔肝脏的影响

Influence of propofol pretreatment on the liver in carbon dioxide pneumoperitoneum of rabbit

关键词:  二氧化碳气腹  异丙酚  预处理  家兔肝脏

Key words:  carbon dioxide pneumoperitoneum  propofol  pretreation  rabbit

摘要:

[目的] 探讨异丙酚预处理对二氧化碳气腹条件下家兔肝脏的保护作用。[方法] 健康家兔28只，雌雄兼备，随机分成4组（n=7）。假手术组（N组）仅用氨基甲酸已酯麻醉，不行气腹处理；二氧化碳气腹组（C组）在麻醉情况下行气腹处理；异丙酚组（P组）在建立气腹后持续输入异丙酚；异丙酚预处理组（PP组）在建立气腹前预先给予异丙酚麻醉后再持续输入，各组动物分别于气腹后0、30、60、90、120 min及气腹结束后60、120 min静脉采血，检测血清ALT、AST、LDH的含量。气腹结束后120 min，处死实验动物，取肝脏组织行病理学检查，并测定其肿瘤坏死因子（TNF-α）、丙二醛（MDA）、超氧化物歧化酶（SOD）、白细胞介素-6（IL-6）含量。[结果] N组在整个实验过程中肝脏酶学无变化，PP组和P组、C组在二氧化碳气腹60 min后血清ALT、AST、LDH开始明显上升，但PP组与P组肝功能各项指标均低于C组（P<0.05），PP组肝功能各项指标低于P组；PP组和P组SOD含量高于C组（P<0.05），但MDA、TNF-α、IL-6含量均低于C组（P<0.05）；PP组SOD含量高于P组（P<0.05），但MDA、TNF-α、IL-6含量均低于P组，N组SOD、MDA、TNF-α、IL-6含量在各时间段保持相对恒定。光镜下C组肝窦明显扩张、淤血，汇管区炎细胞浸润，肝细胞有不同程度的脂肪变性、空泡状变性及点状坏死，PP组和P组肝细胞明显肿胀，但无明显脂肪变性及坏死。[结论] 异丙酚对二氧化碳气腹条件下的家兔肝脏有保护作用，且以预处理保护效果更好。

Abstract:

[Objective] To investigate the effect of propofol preteatment on liver during pneumoperitoneum in rabbits. [Methods] Twenty-eight rabbits were randomly divided into 4 groups (n=7): the Sham group (group N), the carbon dioxide pneumoperitoneum group (group C), the carbon dioxide pneumoperitoneum with propofol group (group P) and the carbon dioxide pneumoperitoneum with propofol pretreatmentgroup (group PP). The pneumoperitoneum of group C, group P and group PP were established during 2 hs. The serums were collected at 0, 30, 60, 90, 120 minutes after pneumoperitoneum for detecting ALT, AST and LDH. Two hour after pneumoperitoneum, the rabbits were terminated and their sera and livers were collected for morphological examination, TNF-α, MDA, superoxide dismutase SOD, IL - 6 of these livers were measured. [Results] At 60 minutes after insufflation of carbon dioxide, the levels of serum ALT, AST, LDH of group C, group P and group PP are significantly increased, but the indicators of liver function of group PP and P were lower than those in group C (P<0.05), while those in group N during the experiment did not change significantly. The changes in group PP were lower than those in group P. The SOD level in group C was lower than those in group P and PP (P<0.05), but the level of MDA, TNF-α, IL-6 were higher than those in group P and PP (P<0.05). The SOD level in group P was lower than that of group PP (P<0.05), while MDA, TNF-α, IL-6 levels in group P were higher than those in group PP. SOD, MDA, TNF-α, IL-6 levels in group N keep stable relatively. The fatty degeneration, vacuolar degeneration and spotty necrosis of hepatocytes and inflammatory cell infiltration in portal area were found in group C, but not clear about the changes in group P and PP. [Conclusion] Propofol has a protective effect on liver under carbon dioxide pneumoperitoneum condition, and would be better when pretreated in rabbits.