Håkanson E, Rutberg H, Jorfeldt L
Clin Physiol. 1986 Oct;6(5):439-51. doi: 10.1111/j.1475-097x.1986.tb00075.x.
Surgical trauma is accompanied by increased energy expenditure and raised arterial concentrations of adrenaline and glucose. In order to study the acute effects of an adrenaline infusion on glucose metabolism and oxygen uptake in the leg and splanchnic bed, adrenaline was administered at a rate giving plasma concentrations of adrenaline similar to those in connection with abdominal surgery. Seven healthy males participated in the study. Adrenaline 40 ng/(min X kg body weight) (0.22 nmol/(min X kg body weight] was infused producing a plasma concentration of 2.77 +/- 0.42 nmol/l (mean +/- SEM). Leg and splanchnic blood flows and the femoral and hepatic arterio-venous differences for oxygen, glucose, lactate and other metabolites were determined. Measurements were made before and between 30 and 40 min after the start of the adrenaline infusion. Following the infusion of adrenaline the leg blood flow increased by 140% and hepatic blood flow by 25%. The leg oxygen uptake increased by 30%, but no significant increase in splanchnic oxygen uptake was observed. The arterial glucose concentration rose by 35%. Splanchnic glucose output increased X 2.5, but no significant increase in leg glucose uptake was observed. Leg release of gluconeogenic substrates increased but only lactate and glycerol uptake increased in the splanchnic bed. Leg blood flow increased more than that usually seen after surgery, whereas leg oxygen uptake and splanchnic oxygen uptake was higher in the immediate postoperative period. Splanchnic glucose release increased more during the infusion than in connection with surgery. It is concluded that adrenaline at a plasma concentration similar to that during and immediately after surgery can induce changes in glucose metabolism which are of the same order or more pronounced than those seen in connection with abdominal surgery.
手术创伤伴随着能量消耗增加以及动脉血中肾上腺素和葡萄糖浓度升高。为了研究肾上腺素输注对腿部和内脏床葡萄糖代谢及氧摄取的急性影响，以能使血浆肾上腺素浓度与腹部手术时相似的速率给予肾上腺素。7名健康男性参与了该研究。以40 ng/（分钟×千克体重）（0.22 nmol/（分钟×千克体重）的速率输注肾上腺素，使血浆浓度达到2.77±0.42 nmol/L（均值±标准误）。测定了腿部和内脏的血流量以及股动脉和肝动脉的氧、葡萄糖、乳酸及其他代谢物的动静脉差值。在肾上腺素输注开始前以及输注开始后30至40分钟之间进行测量。输注肾上腺素后，腿部血流量增加了140%，肝血流量增加了25%。腿部氧摄取增加了30%，但未观察到内脏氧摄取有显著增加。动脉葡萄糖浓度升高了35%。内脏葡萄糖输出增加了2.5倍，但未观察到腿部葡萄糖摄取有显著增加。腿部糖异生底物的释放增加，但内脏床仅乳酸和甘油摄取增加。腿部血流量增加幅度超过了手术后通常所见的幅度，而术后即刻腿部氧摄取和内脏氧摄取更高。输注期间内脏葡萄糖释放增加幅度大于手术时。结论是，血浆肾上腺素浓度与手术期间及术后即刻相似时，可诱导葡萄糖代谢发生变化，其程度与腹部手术时所见相当或更为明显。
