[门腔静脉吻合术治疗肝硬化和门静脉高压患者的葡萄糖耐量和胰岛素血症]

[Glucose tolerance and insulinemia in patients with hepatic cirrhosis and portal hypertension treated by portacaval anastomosis].

作者信息

Postiglione A, Casaretti B, Masciariello S, Riccardi G, Perrotti N, Lamenza F, Porcellini M, Mattioli P L

出版信息

Boll Soc Ital Biol Sper. 1979 Feb 28;55(4):331-7.

Abstract

Development of diabetes mellitus is a common complication of side to side porta-caval anastomosis (PCA). Five patients with liver cirrhosis and portal hypertension have been studied with intravehous (IVGTT, 0,5 g/Kg B.W.) and oral (OGTT, 1 g/Kg B.W.) glucose tolerance tests before and three weeks after PCA. Fasting plasma glucose was 84 +/- 7 before and 87 +/- 3 mg/dl after PCA. Fasting IRI increased from 17 +/- 3 to 31 +/- 6 microU/ml. The pattern of plasma glucose and IRI response to IVGTT did not change after PCA. Plasma glucose resonse to OGTT after PCA showed only an earlier rise at 60 instead of 90 minutes, whereas IRI resonse (area under the insulin curve) was significantly enhanced (from 12.4 to 19.8 U/l, p < 0.05). These data suggest a role of gut polipeptides in determining hyperinsulinemia and insulin resistence in PCA patients.

摘要

糖尿病的发生是侧侧门腔静脉吻合术（PCA）常见的并发症。对5例肝硬化和门静脉高压患者在PCA术前及术后3周进行了静脉（IVGTT，0.5g/kg体重）和口服（OGTT，1g/kg体重）葡萄糖耐量试验。PCA术前空腹血糖为84±7，术后为87±3mg/dl。空腹IRI从17±3升高至31±6μU/ml。PCA术后静脉葡萄糖耐量试验的血糖和IRI反应模式未改变。PCA术后口服葡萄糖耐量试验的血糖反应仅在60分钟而非90分钟出现较早升高，而IRI反应（胰岛素曲线下面积）显著增强（从12.4升至19.8U/l，p<0.05）。这些数据提示肠道多肽在PCA患者高胰岛素血症和胰岛素抵抗的发生中起作用。