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吗啡所致高血糖症

Morphine hyperglycaemia.

作者信息

Feldberg W, Gupta K P

出版信息

J Physiol. 1974 May;238(3):487-502. doi: 10.1113/jphysiol.1974.sp010539.

Abstract
  1. To find the site where morphine acts when producing hyperglycaemia on injection into the cerebral ventricles in unanaesthetized cats, morphine sulphate was infused or injected through an implanted Collison cannula into different parts of the liquor space in an amount of 0.75 mg except on microinfusion into the posterior hypothalamus, when the amounts were 80 or 160 mug. The glucose was determined in blood samples collected from the inferior vena cava.2. Microinfusions of morphine into the posterior hypothalamus did not produce hyperglycaemia.3. Infusion of morphine into the liquor space at the entrance of the aqueduct or of the fourth ventricle produced hyperglycaemia. Any structures in the walls of the third ventricle as well as the peri-aqueductal grey are thus excluded as the site of action.4. Infusion of morphine into the subarachnoid space just above the corpora quadrigemina or below the ventral surface of the brain stem produced hyperglycaemia. With these routes the morphine does not enter any part of the ventricular cavities and the action would appear to be on structures at the ventral surface of the brain stem.5. Injection of morphine into the cisterna magna produces hyperglycaemia when the doses are larger than those already effective on injection into the cerebral ventricles. This also suggests an action on structures at the ventral surface of the brain stem, as this surface is reached more readily from the ventricles than from the cisterna.6. It is concluded that on injection into the cerebral ventricles, the morphine has to pass into the subarachnoid space, through the foramina of Luschka, in order to produce hyperglycaemia. It then reaches the ventral surface of the brain stem and probably acts there on structures in the upper part of the medulla oblongata.7. Infusion of morphine into the corpora quadrigemina near the caudal end of the superior corpora can produce profound hypoglycaemia.8. Anaesthesia depresses the morphine hyperglycaemia, but when the dose injected into the cerebral ventricles is increased four times or more, hyperglycaemia is also produced in pentobarbitone sodium anaesthesia.
摘要
  1. 为了找到未麻醉猫脑室内注射吗啡导致高血糖时吗啡的作用部位,通过植入的柯里逊套管将硫酸吗啡注入或注射到不同部位的脑脊液间隙中,除了微量注入下丘脑后部时剂量为80或160微克外,其他部位剂量均为0.75毫克。从下腔静脉采集血样测定葡萄糖含量。

  2. 向下丘脑后部微量注射吗啡未引起高血糖。

  3. 向中脑导水管入口处或第四脑室的脑脊液间隙注入吗啡会导致高血糖。因此,第三脑室壁以及中脑导水管周围灰质中的任何结构都被排除作为作用部位。

  4. 向四叠体上方或脑干腹面下方的蛛网膜下腔注入吗啡会导致高血糖。通过这些途径,吗啡不会进入脑室腔的任何部分,其作用似乎是在脑干腹面的结构上。

  5. 当剂量大于脑室内注射已有效的剂量时,向小脑延髓池注射吗啡会导致高血糖。这也表明是对脑干腹面结构的作用,因为从脑室比从小脑延髓池更容易到达该表面。

  6. 得出结论,脑室内注射时,吗啡必须通过卢施卡孔进入蛛网膜下腔才能导致高血糖。然后它到达脑干腹面,可能作用于延髓上部的结构。

  7. 向上丘尾端附近的四叠体注入吗啡可导致严重低血糖。

  8. 麻醉会抑制吗啡引起的高血糖,但当脑室内注射剂量增加四倍或更多时,戊巴比妥钠麻醉下也会出现高血糖。

相似文献

1
Morphine hyperglycaemia.吗啡所致高血糖症
J Physiol. 1974 May;238(3):487-502. doi: 10.1113/jphysiol.1974.sp010539.
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The hyperglycaemic effect of morphine.吗啡的高血糖作用。
Br J Pharmacol. 1972 Dec;46(4):602-18. doi: 10.1111/j.1476-5381.1972.tb06887.x.
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A vasodepressor effect of pentobarbitone sodium.戊巴比妥钠的血管减压作用。
J Physiol. 1972 Jul;224(1):83-103. doi: 10.1113/jphysiol.1972.sp009882.
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Localization of the central cardiovascular action of clonidine.可乐定的中枢心血管作用定位
Br J Pharmacol. 1973 Dec;49(4):573-9. doi: 10.1111/j.1476-5381.1973.tb08532.x.

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Morphine induces desensitization of insulin receptor signaling.吗啡会导致胰岛素受体信号脱敏。
Mol Cell Biol. 2003 Sep;23(17):6255-66. doi: 10.1128/MCB.23.17.6255-6266.2003.
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Opioid peptides and metabolic regulation.阿片肽与代谢调节。
Diabetologia. 1988 Jan;31(1):3-15. doi: 10.1007/BF00279126.

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J Physiol. 1971 Sep;217(3):547-56. doi: 10.1113/jphysiol.1971.sp009585.
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A vasodepressor effect of pentobarbitone sodium.戊巴比妥钠的血管减压作用。
J Physiol. 1972 Jul;224(1):83-103. doi: 10.1113/jphysiol.1972.sp009882.
8
The hyperglycaemic effect of morphine.吗啡的高血糖作用。
Br J Pharmacol. 1972 Dec;46(4):602-18. doi: 10.1111/j.1476-5381.1972.tb06887.x.

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