Fink A S, DeMar A R, Gettys T W, Taylor I L
Department of Surgery, University of California, Los Angeles.
Pancreas. 1990 May;5(3):323-9. doi: 10.1097/00006676-199005000-00012.
In previous studies, postprandial pancreatic polypeptide (PP) release was diminished when pancreatic denervation was combined with distal pancreatectomy in animals without chronic fistulae. In contrast, postprandial PP release was reported to be unchanged when the pancreas was denervated without performing a distal pancreatectomy. These findings were unexpected given that the distal pancreas is a PP-poor region. To clarify this issue, we performed extrinsic pancreatic denervation, distal pancreatectomy, and insertion of chronic pancreatic fistulae in nine mongrel dogs. Insulin (0.5 U/kg) and meal-stimulated PP release were measured pre- and postoperatively. In addition, insulin- and meal-induced exocrine secretion was measured postoperatively. Preoperatively, insulin-induced hypoglycemia stimulated significant PP release (80,553 +/- 18,540 pg/min/ml). This response was completely abolished postoperatively (-1,669 +/- 5,054 pg/min/ml). Exocrine secretion did not increase above basal levels after administration of insulin in postoperative animals. These findings suggest adequate pancreatic denervation. Ingestion of a meal evoked significant PP response preoperatively (97,909 +/- 18,394 pg/min/ml). Postoperatively, the response was significantly blunted (17,231 +/- 6,407 pg/min/ml). This finding is in contrast to a previous report using a similar experimental preparation without distal pancreatic resection. We speculate that although the distal pancreas is PP-poor, it may play a role in the regulation of PP release from the PP-rich pancreatic head.
在先前的研究中，对于没有慢性瘘管的动物，当胰腺去神经支配与胰腺远端切除术联合进行时，餐后胰多肽（PP）释放减少。相比之下，据报道，在未进行胰腺远端切除术的情况下对胰腺进行去神经支配时，餐后PP释放没有变化。鉴于胰腺远端是PP含量较低的区域，这些发现出乎意料。为了阐明这个问题，我们对9只杂种犬进行了胰腺外去神经支配、胰腺远端切除术和慢性胰瘘植入。在术前和术后测量胰岛素（0.5 U/kg）和进餐刺激后的PP释放。此外，在术后测量胰岛素和进餐诱导的外分泌。术前，胰岛素诱导的低血糖刺激了显著的PP释放（80,553±18,540 pg/min/ml）。术后这种反应完全消失（-1,669±5,054 pg/min/ml）。术后给予胰岛素后，外分泌没有增加到基础水平以上。这些发现表明胰腺去神经支配充分。术前进餐引起了显著的PP反应（97,909±18,394 pg/min/ml）。术后，反应明显减弱（17,231±6,407 pg/min/ml）。这一发现与先前使用类似实验制剂但未进行胰腺远端切除的报告相反。我们推测，尽管胰腺远端PP含量低，但它可能在富含PP的胰头PP释放调节中起作用。
