Schlienger J L, Imler M
C R Seances Soc Biol Fil. 1979;173(3):585-91.
Arterio-venous differences of glucose and glutamine were determined across the brain and across the hind limb in normal and ammonium salt infused rats, before and during an insulin tolerance test, in an attempt to study the effect of hyperammonemia on cephalic and muscular metabolism. The results demonstrate that 1) hyperammonemia reduces the hind limb uptake of glucose without affect the cephalic uptake of glucose which is lowered during hypoglycemia, 2) the reduction of the cephalic and muscular glutamine output induced by the hypoglycemia is masked in presence of an hyperammonemia. In conclusion, it may be assume that, at the concentration obtained in this study, hyperammonemia does not act directly in the pathogenesis of hepatic coma in which a decrease in cerebral glucose uptake described; on the other hand, ammonium plays an important role in the muscle metabolism.
在正常大鼠和输注铵盐的大鼠中，于胰岛素耐量试验之前及期间，测定了大脑和后肢的葡萄糖及谷氨酰胺动静脉差异，以研究高氨血症对头部和肌肉代谢的影响。结果表明：1）高氨血症会降低后肢对葡萄糖的摄取，但不影响头部对葡萄糖的摄取，而在低血糖期间头部对葡萄糖的摄取会降低；2）在高氨血症存在的情况下，低血糖诱导的头部和肌肉谷氨酰胺输出的减少被掩盖。总之，可以推测，在本研究获得的浓度下，高氨血症并不直接参与肝性昏迷的发病机制，肝性昏迷中描述有脑葡萄糖摄取减少；另一方面，铵在肌肉代谢中起重要作用。
