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[全胰切除术对人生长激素分泌及内分泌胰腺的影响]

[Influence of total pancreatectomy on the secretion of human growth hormone and the endocrine pancreas].

作者信息

Takaesu Y, Nimura Y, Hayakawa N, Yasui K, Ohtsuka K

机构信息

1st Department of Surgery, Nagoya University School of Medicine, Japan.

出版信息

Nihon Geka Gakkai Zasshi. 1988 Oct;89(10):1686-91.

PMID:3059167
Abstract

To evaluate the effect of total pancreatectomy on the secretion of human growth hormone, twenty-six patients undergoing total pancreatectomy and twelve healthy subjects (controls) were investigated. Blood glucose (BG), plasma insulin (IRI), C-peptide (CPR), immunoreactive glucagon (IRG) and human growth hormone (HGH) levels were determined. In the glucose tolerance test, the mean basal blood glucose level in the patients before operation was significantly higher than the level in the controls. The basal blood glucose level in the patients after operation was still higher than the level before operation. The responses of IRI, CPR, and IRG secretion after arginine infusion in the patients before operation were less than those in the controls. After operation, arginine infusion did not alter the levels of IRI, CPR and IRG. The mean basal HGH levels were not significantly different between the controls and the patients before and after operation. However, a statistically significant correlation was shown between the basal values of plasma HGH and those of plasma IRI in the patients after operation. Thus, it suggested that the basal secretion of HGH is closely related to the exogenous plasma insulin levels in the pancreatectomized patients. After arginine infusion, the HGH levels in the patients before operation were lower than the those in the controls, but insignificant. After operation, mean HGH levels were significantly lower than those before operation. These findings suggested the absence of pancreatic endocrine function caused by total pancreatectomy resulted in decreased responses of HGH secretion after arginine infusion.

摘要

为评估全胰切除术对人生长激素分泌的影响,对26例行全胰切除术的患者和12名健康受试者(对照组)进行了研究。测定了血糖(BG)、血浆胰岛素(IRI)、C肽(CPR)、免疫反应性胰高血糖素(IRG)和人生长激素(HGH)水平。在葡萄糖耐量试验中,患者术前的平均基础血糖水平显著高于对照组。患者术后的基础血糖水平仍高于术前。术前患者在输注精氨酸后IRI、CPR和IRG分泌的反应低于对照组。术后,输注精氨酸未改变IRI、CPR和IRG的水平。对照组与术前及术后患者的平均基础HGH水平无显著差异。然而,术后患者血浆HGH的基础值与血浆IRI的基础值之间显示出统计学上的显著相关性。因此,提示全胰切除术后患者HGH的基础分泌与外源性血浆胰岛素水平密切相关。输注精氨酸后,术前患者的HGH水平低于对照组,但差异不显著。术后,平均HGH水平显著低于术前。这些发现表明,全胰切除术导致的胰腺内分泌功能缺失导致输注精氨酸后HGH分泌反应降低。

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