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[全胰切除术后葡萄糖代谢及氨基酸代谢的实验研究]

[Experimental study on glucose turnover and amino acid metabolism after total pancreatectomy].

作者信息

Mishina T

机构信息

First Surgical Department, Niigata University, School of Medicine, Japan.

出版信息

Nihon Geka Gakkai Zasshi. 1988 Apr;89(4):568-75.

PMID:3043166
Abstract

Glucose turnover and plasma amino acid profile were measured in total pancreatectomized dogs to clarify the mechanism of hyperaminoacidemia after total pancreatectomy. Twenty-one male mongrel dogs underwent total gastrectomy and pancreatectomy and were divided into two groups. I(-) group (n = 11) was treated without insulin and I(+) group (n = 10) received insulin postoperatively. Another 15 dogs of S group received only splenectomy. Glucose appearance rate (Ra), plasma amino acid profile and blood sugar level (BS) were measured before operation, and on the 1st and 3rd postoperative days. Significantly higher Ra and BS were observed in I(-) group than in S group postoperatively and either decreased or unaltered by the glucagon infusion. On the other hand, Ra and BS in I(+) group were maintained at the same levels as S group and increased significantly by the glucagon infusion. Hyperaminoacidemia was observed after total pancreatectomy regardless of insulin treatment. Branched chain amino acids (BCAA) were significantly elevated in I(-) group but not in I(+) group. Glucagon infusion decreased almost all amino acids levels except BCAA in both groups. These results suggest that mechanism of hyperaminoacidemia observed in totally pancreatectomized dogs is the reduced amino acids uptake by the liver related to glucagon deficiency.

摘要

为阐明全胰切除术后高氨基酸血症的机制,对全胰切除的犬进行了葡萄糖周转率和血浆氨基酸谱的测定。21只雄性杂种犬接受了全胃切除术和胰腺切除术,并分为两组。I(-)组(n = 11)未接受胰岛素治疗,I(+)组(n = 10)术后接受胰岛素治疗。另外15只S组犬仅接受脾切除术。在术前、术后第1天和第3天测量葡萄糖出现率(Ra)、血浆氨基酸谱和血糖水平(BS)。术后I(-)组的Ra和BS显著高于S组,且胰高血糖素输注后二者降低或未改变。另一方面,I(+)组的Ra和BS维持在与S组相同的水平,且胰高血糖素输注后显著升高。无论胰岛素治疗情况如何,全胰切除术后均观察到高氨基酸血症。I(-)组支链氨基酸(BCAA)显著升高,而I(+)组未升高。胰高血糖素输注使两组中除BCAA外的几乎所有氨基酸水平降低。这些结果表明,全胰切除犬中观察到的高氨基酸血症机制是与胰高血糖素缺乏相关的肝脏氨基酸摄取减少。

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