Doffoël M, Brandt C M, Vetter D, Ventre G, Charrault A, Bockel R
Gastroenterol Clin Biol. 1987 Feb;11(2):123-7.
The effect of the intravenous injection of 0.1 mg/kg of propranolol on arterial ammonemia was studied in 30 patients with alcoholic cirrhosis comparatively with 10 healthy volunteers. Moreover, in 20 patients in the cirrhotic group (10 were Pugh's grade A or B and 10 others were grade C), left renal vein catheterization was performed to follow the changes in ammonemia and glutaminemia levels simultaneously with those occurring in arterial blood. After 30 min, arterial ammonemia was significantly increased in the controls (p less than 0.02) and in the cirrhotic patients (p less than 0.001). The renal venous ammonemia was also significantly increased in all of the cirrhotic patients (p less than 0.01). In the grade A and B patients, the increase in ammonemia was more marked in the renal vein as compared with that in arterial blood (p less than 0.001). In contrast, in the grade C patients, the increase in ammonemia did not differ significantly between the two sectors. The difference in ammonia concentration between arterial and renal venous blood increased significantly after 30 min in the grade A and B patients (p less than 0.001) whereas it was stable in the grade C patients. The changes of glutaminemia in arterial and renal venous blood were not significantly different in the two groups of cirrhotic patients. These data show that, in our experimental conditions, propranolol induces arterial hyperammonemia in cirrhotic patients and that the kidney could interfere with the mechanism of hyperammonemia, at least in grade A and B patients.
对30例酒精性肝硬化患者静脉注射0.1mg/kg普萘洛尔对动脉血氨水平的影响进行了研究，并与10名健康志愿者进行了比较。此外，在肝硬化组的20例患者中（10例为普格分级A或B级，另外10例为C级），进行了左肾静脉插管，以同时跟踪血氨和谷氨酰胺水平与动脉血中发生的变化。30分钟后，对照组（p<0.02）和肝硬化患者（p<0.001）的动脉血氨水平均显著升高。所有肝硬化患者的肾静脉血氨水平也显著升高（p<0.01）。在A和B级患者中，肾静脉血氨的升高比动脉血更为明显（p<0.001）。相比之下，在C级患者中，两个部位血氨的升高没有显著差异。A和B级患者在30分钟后动脉血和肾静脉血之间的氨浓度差异显著增加（p<0.001），而C级患者则保持稳定。两组肝硬化患者动脉血和肾静脉血中谷氨酰胺水平的变化没有显著差异。这些数据表明，在我们的实验条件下，普萘洛尔可导致肝硬化患者出现动脉血氨升高，并且肾脏可能会干扰血氨升高的机制，至少在A和B级患者中是这样。
