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动脉或门静脉缺血对部分和完全胰腺切除犬的生存及代谢的影响。

Effects of arterial or portal ischemia on survival and metabolism of partially and totally depancreatized dogs.

作者信息

Rappaport A M, Kawamura T, Knoblauch M, Cowan J S, Ohira S, Kalnins A, Empey G

出版信息

Z Exp Chir. 1975;8(6):326-42.

PMID:1053192
Abstract

The role of arterial blood flow in hepatic metabolic functions was compared to that of portal flow in two groups of totally depancreatized dogs. Survival times and glucose and nitrogen excretion were significantly greater in dogs with ligation of the hepatic artery than in dogs with an Eck fistula. The dogs with ligated hepatic arteries also showed a significantly slower rise in plasma ketones. The course of diabetes was compared in three additional groups of partially depancreatized dogs consisting of a) dogs with ligated hepatic arteries, b) dogs with Eck fistulas, and c) controls. Hepatic arterial ischemia: 1) increased survival, without insulin treatment (a--650, b--167, c--124 days) 2) did not decrease tracer-determined rate of glucose production 3) led to a greater urinary excretion of glucose, ketone bodies and nitrogen than portal ischemia. Partially depancreatized dogs with either arterial or portal hepatic ischemia maintained a high rate of glucose disappearance on acute deprivation of endogenous insulin (clamping of vessels of their pancreatic remnant) due probably to decreased insulin degradation by the ischemic liver. The dogs died in coma after losing all fat depots. There was severe fatty change in the livers of dogs with hepatic artery ligation, slight in those with Eck fistulas and no fat in the livers of controls.

摘要

在两组完全胰腺切除的狗中,比较了肝动脉血流和门静脉血流在肝脏代谢功能中的作用。肝动脉结扎的狗的存活时间、葡萄糖和氮排泄量显著高于患有艾克瘘管的狗。肝动脉结扎的狗血浆酮体升高也明显较慢。在另外三组部分胰腺切除的狗中比较了糖尿病病程,这三组包括:a)肝动脉结扎的狗,b)患有艾克瘘管的狗,c)对照组。肝动脉缺血:1)在未进行胰岛素治疗的情况下提高了存活率(a组——650天,b组——167天,c组——124天)2)未降低示踪剂测定的葡萄糖生成率3)与门静脉缺血相比,导致葡萄糖、酮体和氮的尿排泄量增加。部分胰腺切除且伴有肝动脉或门静脉缺血的狗在急性内源性胰岛素缺乏(钳夹其胰腺残端血管)时,葡萄糖消失率维持在较高水平,这可能是由于缺血肝脏对胰岛素的降解减少所致。狗在失去所有脂肪储备后死于昏迷。肝动脉结扎的狗肝脏有严重的脂肪变性,患有艾克瘘管的狗肝脏有轻微脂肪变性,对照组狗肝脏无脂肪。

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