Ljungqvist O, Sandberg E, Nylander G, Ware J
Department of Surgery, Karolinska Hospital and Institute, Stockholm, Sweden.
Circ Shock. 1989 Aug;28(4):347-56.
Haemorrhagic hyperglycemia has been demonstrated to have beneficial effects on fluid homeostasis, and insulin resistance has been reported in vitro after haemorrhage. In the present study the interrelation of peripheral levels of insulin, glucagon, and adrenalin and the rate of glucose disappearance (Rd) in haemorrhagic hyperglycemia were determined in vivo. Rd was determined by single injection of 3-3H-glucose in three groups of postprandial rats: controls, rats submitted to rapid blood loss, and rats receiving a constant 30% glucose infusion. The level of hyperglycemia after bleeding was 22.9 +/- 1.9 mmol x 1(-1) (mean +/- 1 S.E.), and during infusion it was 20.4 +/- 1.4 mmol x 1(-1). The Rd value of controls was 8.2 +/- 0.5 mmol x 100 g-1 x min-1, during glucose infusion it was 34.1 +/- 0.6, and after haemorrhage it was 9.7 +/- 0.4. Both treatments increased insulin levels by greater than 200%. These results show an important role of insulin resistance in causing hyperglycemia after experimental haemorrhage in the rat.
出血性高血糖已被证明对液体平衡具有有益作用,并且在出血后的体外实验中已报道存在胰岛素抵抗。在本研究中,在体内测定了出血性高血糖状态下胰岛素、胰高血糖素和肾上腺素的外周水平与葡萄糖消失率(Rd)之间的相互关系。通过对三组餐后大鼠单次注射3-3H-葡萄糖来测定Rd:对照组、经历快速失血的大鼠以及接受持续30%葡萄糖输注的大鼠。出血后的高血糖水平为22.9±1.9 mmol×1(-1)(平均值±1个标准误),输注期间为20.4±1.4 mmol×1(-1)。对照组的Rd值为8.2±0.5 mmol×100 g-1×min-1,葡萄糖输注期间为34.1±0.6,出血后为9.7±0.4。两种处理均使胰岛素水平升高超过200%。这些结果表明胰岛素抵抗在大鼠实验性出血后导致高血糖中起重要作用。