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门腔分流术后早期脑功能障碍的发生

Early establishment of cerebral dysfunction after portacaval shunting.

作者信息

Mans A M, DeJoseph M R, Davis D W, Viña J R, Hawkins R A

机构信息

Department of Anesthesia, Pennsylvania State University College of Medicine, Milton S. Hershey Medical Center, Hershey 17033.

出版信息

Am J Physiol. 1990 Jul;259(1 Pt 1):E104-10. doi: 10.1152/ajpendo.1990.259.1.E104.

Abstract

Portacaval shunting in rats results in brain dysfunction, as indicated by reduced energy metabolism and behavioral abnormalities, as well as many biochemical changes in plasma and brain. No etiological connections have been made between these findings, which have been studied mainly 2 wk or more after shunting. To determine how soon the various abnormalities occur and which are associated temporally with the decrease in brain glucose use, we studied shunted and sham-operated rats between 6 h and 11 days after surgery. Six hours after portacaval shunting, plasma aromatic amino acids, brain glutamine, aromatic amino acids, 5-hydroxyindoleacetic acid, and tryptophan transport into the brain were all significantly higher than normal. Brain glucose use showed a downward trend and was fully depressed within 1 day. Plasma branched-chain amino acids and threonine were decreased, and brain serotonin and norepinephrine content increased only after 2 days; these changes were therefore dissociated from the other abnormalities that developed in a shorter period. The results showed that the cerebral dysfunction characteristic of portacaval shunting began within hours and was fully established by 2 days.

摘要

大鼠门腔分流会导致脑功能障碍,表现为能量代谢降低、行为异常,以及血浆和脑组织中的许多生化变化。这些研究结果之间尚未建立病因联系,相关研究主要在分流后2周或更长时间进行。为了确定各种异常情况多快出现,以及哪些异常与脑葡萄糖利用减少在时间上相关,我们对分流大鼠和假手术大鼠在术后6小时至11天进行了研究。门腔分流术后6小时,血浆芳香族氨基酸、脑谷氨酰胺、芳香族氨基酸、5-羟吲哚乙酸和色氨酸向脑内的转运均显著高于正常水平。脑葡萄糖利用呈下降趋势,并在1天内完全降低。血浆支链氨基酸和苏氨酸减少,脑血清素和去甲肾上腺素含量仅在2天后增加;因此,这些变化与在较短时间内出现的其他异常情况无关。结果表明,门腔分流的脑功能障碍特征在数小时内开始,并在2天内完全形成。

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