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静脉输注葡萄糖的途径对清醒犬肝脏葡萄糖平衡的重要性。

Importance of the route of intravenous glucose delivery to hepatic glucose balance in the conscious dog.

作者信息

Adkins B A, Myers S R, Hendrick G K, Stevenson R W, Williams P E, Cherrington A D

出版信息

J Clin Invest. 1987 Feb;79(2):557-65. doi: 10.1172/JCI112847.

Abstract

To assess the importance of the route of glucose delivery in determining net hepatic glucose balance (NHGB) eight conscious overnight-fasted dogs were given glucose via the portal or a peripheral vein. NHGB was measured using the arteriovenous difference technique during a control and two 90-min glucose infusion periods. The sequence of infusions was randomized. Insulin and glucagon were held at constant basal levels using somatostatin and intraportal insulin and glucagon infusions during the control, portal, and peripheral glucose infusion periods (7 +/- 1, 7 +/- 1, 7 +/- 1 microU/ml; 100 +/- 3, 101 +/- 6, 101 +/- 3 pg/ml, respectively). In the three periods the hepatic blood flow, glucose infusion rate, arterial glucose level, hepatic glucose load, arterial-portal glucose difference and NHGB were 37 +/- 1, 34 +/- 1, 32 +/- 3 ml/kg per min; 0 +/- 0, 4.51 +/- 0.57, 4.23 +/- 0.34 mg/kg per min; 101 +/- 5, 200 +/- 15, 217 +/- 13 mg/dl; 28.5 +/- 3.5, 57.2 +/- 6.7, 54.0 +/- 6.4 mg/kg per min; +2 +/- 1, -22 +/- 3, +4 +/- 1 mg/dl; and 2.22 +/- 0.28, -1.41 +/- 0.31, and 0.08 +/- 0.23 mg/kg per min, respectively. Thus when glucose was delivered via a peripheral vein the liver did not take up glucose but when a similar glucose load was delivered intraportally the liver took up 32% (P less than 0.01) of it. In conclusion portal glucose delivery provides a signal important for the normal hepatic-peripheral distribution of a glucose load.

摘要

为评估葡萄糖输注途径在决定肝脏葡萄糖净平衡(NHGB)中的重要性,对8只清醒的过夜禁食犬经门静脉或外周静脉给予葡萄糖。在对照期和两个90分钟的葡萄糖输注期,采用动静脉差值技术测量NHGB。输注顺序是随机的。在对照期、门静脉葡萄糖输注期和外周葡萄糖输注期,使用生长抑素以及门静脉内胰岛素和胰高血糖素输注,将胰岛素和胰高血糖素维持在恒定的基础水平(分别为7±1、7±1、7±1微单位/毫升;100±3、101±6、101±3皮克/毫升)。在这三个时期,肝血流量、葡萄糖输注速率、动脉葡萄糖水平、肝脏葡萄糖负荷、动脉-门静脉葡萄糖差值和NHGB分别为37±1、34±1、32±3毫升/千克每分钟;0±0、4.51±0.57、4.23±0.34毫克/千克每分钟;101±5、200±15、217±13毫克/分升;28.5±3.5、57.2±6.7、54.0±6.4毫克/千克每分钟;+2±1、-22±3、+4±1毫克/分升;以及2.22±0.28、-1.41±0.31、0.08±0.23毫克/千克每分钟。因此,当经外周静脉输注葡萄糖时,肝脏不摄取葡萄糖,但当经门静脉给予相似的葡萄糖负荷时,肝脏摄取其中的32%(P<0.01)。总之,门静脉葡萄糖输注为葡萄糖负荷在肝脏-外周的正常分布提供了一个重要信号。

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