Thompson J S, Schafer D F, Schafer G J, Hodgson P E
J Surg Res. 1985 Feb;38(2):143-8. doi: 10.1016/0022-4804(85)90020-4.
It has been hypothesized that gamma-aminobutyric acid (GABA), the principle inhibitory neurotransmitter of the mammalian brain, contributes to the neural inhibition of hepatic encephalopathy. Eck fistulae were created in seven dogs and celiotomy alone performed in five dogs to determine plasma GABA levels, brain GABA binding, and synaptic membrane changes in dogs after creation of Eck fistulae. Eck fistula dogs lost 19 +/- 9% body weight, lost hair, ate poorly, and developed atrophic livers with classic hepatic histological changes. Control dogs maintained body weight, normal behavior, and normal liver histology. Plasma GABA levels were elevated significantly in the Eck fistula dogs (312 +/- 105.9 nM) both as compared to controls (154.4 +/- 69.8) and to preoperative levels (161.6 +/- 56.7, P less than 0.05). Brain GABA binding for animals sacrificed at 6-9 weeks was not statistically different from sham-operated dogs sacrificed at 6 weeks (1.87 +/- .54 pmole/mg protein vs 1.186 +/- 24, P less than 0.2). Synaptic membrane fluidity and cholesterol were likewise unchanged. Plasma GABA levels are increased significantly following complete portal diversion but do not correlate with the degree of encephalopathy. GABA binding to neural membranes are not significantly increased in Eck fistula dogs. These findings do not support a direct relationship between plasma GABA levels and neurologic impairment in Eck fistula dogs.
据推测,γ-氨基丁酸(GABA)作为哺乳动物大脑主要的抑制性神经递质,与肝性脑病的神经抑制有关。对7只犬制作了 Eck 瘘,另5只犬仅进行剖腹术,以测定制作 Eck 瘘后犬的血浆GABA水平、脑GABA结合及突触膜变化。制作 Eck 瘘的犬体重减轻19±9%,脱毛,进食不佳,并出现肝脏萎缩及典型的肝脏组织学改变。对照犬体重、行为及肝脏组织学均正常。与对照组(154.4±69.8)及术前水平(161.6±56.7,P<0.05)相比,制作 Eck 瘘的犬血浆GABA水平显著升高(312±105.9 nM)。6-9周时处死动物的脑GABA结合与6周时处死的假手术犬无统计学差异(1.87±0.54 pmole/mg蛋白对1.186±0.24,P<0.2)。突触膜流动性及胆固醇同样未改变。完全门静脉分流后血浆GABA水平显著升高,但与脑病程度无关。制作 Eck 瘘的犬中,GABA与神经膜的结合未显著增加。这些发现不支持制作 Eck 瘘的犬血浆GABA水平与神经功能损害之间存在直接关系。