Kasahara H, Ohyanagi H, Saitoh Y
First Department of Surgery, Kobe University, School of Medicine, Japan.
Nihon Geka Gakkai Zasshi. 1988 Mar;89(3):365-75.
Gluconeogenesis and alanine metabolism of normal and cirrhotic rats were studied in view of partial hepatectomy. Liver cirrhosis was made by repeated injection of thioacetamide in rat. Partial hepatectomy was performed by modified method of Higgins-Anderson. Liver glycogen and fructose-2, 6-bisphosphate were decreased after hepatectomy and recovered within 7 days in normal groups, while those of cirrhotic group reduced even in preoperative state were further decreased and hardly recovered after hepatectomy. Gluconeogenesis of perfused liver in cirrhosis was increased from both lactate and alanine preoperatively, but gluconeogenesis from alanine was not increased in both hepatectomized rats. ATP and energy charge were decreased after hepatectomy and recovered within two weeks. These level were lower in cirrhotic group, and decreased further and hardly recovered after hepatectomy. Alanine utilization to CO2 in vivo was not impaired in cirrhotic group either preoperatively or postoperatively. ATP and energy charge were increased by alanine injection in hepatectomized rats of both normal and cirrhotic group. In conclusion, glucose-insulin therapy of sufficient amounts is important to improve decreased glycolysis and abnormal gluconeogenesis on both post-hepatectomy period of normal and pre and post-hepatectomy period of cirrhosis. Also alanine is effective for stimulating decreased energy production.
鉴于部分肝切除术，对正常大鼠和肝硬化大鼠的糖异生及丙氨酸代谢进行了研究。通过向大鼠反复注射硫代乙酰胺来诱导肝硬化。采用改良的希金斯 - 安德森方法进行部分肝切除术。肝切除术后，正常组的肝糖原和果糖 - 2,6 - 二磷酸减少，并在7天内恢复，而肝硬化组即使在术前状态下就已降低的这些指标，在肝切除术后进一步下降且几乎无法恢复。肝硬化大鼠灌注肝脏的糖异生在术前从乳酸和丙氨酸两者均增加，但在肝切除的大鼠中，来自丙氨酸的糖异生在两者中均未增加。肝切除术后ATP和能荷降低，并在两周内恢复。这些水平在肝硬化组中较低，且在肝切除术后进一步下降且几乎无法恢复。肝硬化组术前和术后体内丙氨酸向二氧化碳的利用均未受损。正常组和肝硬化组肝切除大鼠注射丙氨酸后ATP和能荷均增加。总之，足量的葡萄糖 - 胰岛素治疗对于改善正常大鼠肝切除术后以及肝硬化大鼠肝切除术前和术后糖酵解降低和糖异生异常很重要。此外，丙氨酸对于刺激降低的能量产生有效。
