van Hoorn-Hickman R, Vinik A I, van Hoorn W A
Am J Clin Nutr. 1979 Oct;32(10):2009-15. doi: 10.1093/ajcn/32.10.2009.
Hypergastrinemia and hyperglucagonemia follow portacaval shunt (PCS) or cirrhosis in man and experimental animals. The cause is unknown although portal diversion and hepatic dysfunction are suggested. In these studies transhepatic techniques were used to define the hepatic handling of basal and arginine-stimulated gastrin and glucagon levels in sham-operated and portacaval-shunted pigs and in a group of pair-fed sham-operated pigs. After PCS, basal gastrin levels were lower than those in sham-operated animals but were also lower in the pair-fed group, suggesting that the change resulted from partial starvation. Arginine-stimulation caused a rise in hepatic venous levels in PCS and in pair-fed pigs and in portal venous levels in sham-operated pigs. These data also suggested a response to diminished intake in PCS pigs. There was an immediate transitory rise in portal immunoreactive glucagon (Unger 30K) after PCS and a subsequent rise from the 4th postoperative day in all circulations. Arginine stimulation caused in sham-operated and PCS pigs a biphasic rise in the portal circulation and a later rise in the arterial circulation in PCS pigs. These data suggest that the effect of PCS upon gastrin levels is associated with the impaired appetite while the effect upon glucagon is the result of diversion past the liver.
门腔分流术（PCS）或肝硬化后，人类和实验动物会出现高胃泌素血症和高胰高血糖素血症。尽管提示门静脉分流和肝功能障碍，但病因不明。在这些研究中，采用经肝技术来确定假手术猪、门腔分流猪以及一组配对饲养的假手术猪对基础和精氨酸刺激的胃泌素及胰高血糖素水平的肝脏处理情况。PCS后，基础胃泌素水平低于假手术动物，但在配对饲养组中也较低，这表明这种变化是由部分饥饿导致的。精氨酸刺激使PCS猪和配对饲养猪的肝静脉水平升高，使假手术猪的门静脉水平升高。这些数据还提示PCS猪对摄入量减少有反应。PCS后门静脉免疫反应性胰高血糖素（昂格尔30K）立即出现短暂升高，随后在所有循环中从术后第4天开始升高。精氨酸刺激使假手术猪和PCS猪的门静脉循环出现双相升高，使PCS猪的动脉循环在稍后出现升高。这些数据表明，PCS对胃泌素水平的影响与食欲受损有关，而对胰高血糖素的影响是绕过肝脏分流的结果。
