Schlienger J L, Imler M
Clin Chim Acta. 1978 Jan 2;82(1-2):61-7. doi: 10.1016/0009-8981(78)90026-8.
In order to investigate the controverted effect of glucose on hyperammonemia the diet of eight advanced cirrhotics was supplemented hourly, between 9 a.m. and 5 p.m., with 20 g of glucose orally. Plasma insulin and arterial and median cubital venous ammonia levels were measured hourly and the results were compared to those of a control test performed in the same patients without glucose supplementation. In the control test the lunch (protein meal) induced an identical rise in arterial and venous ammonia levels (+40 +/- 3 and +36 +/- 5 microgram/100 ml, respectively). With glucose supplementation plasma insulin rose significantly and the arterial ammonia increase produced by lunch (+42 +/- 3 microgram/100 ml) did not differ from that observed in the control test; but the rise in venous ammonemia was lower (+12 +/- 4 microgram/100 ml; p less than 0.01) with a significant increase in arterio-venous ammonia difference. These results suggest that oral glucose administration increases the peripheral muscular ammonia uptake through a mechanism which remains to be elucidated but which is inefficient for arterial hyperammonemia.
为了研究葡萄糖对高氨血症的争议性作用，在上午9点至下午5点之间，每小时给8例晚期肝硬化患者口服补充20克葡萄糖。每小时测量血浆胰岛素、动脉血和肘正中静脉血氨水平，并将结果与同一患者在不补充葡萄糖情况下进行的对照试验结果进行比较。在对照试验中，午餐（蛋白质餐）使动脉血和静脉血氨水平出现相同幅度的升高（分别为+40±3和+36±5微克/100毫升）。补充葡萄糖后，血浆胰岛素显著升高，午餐引起的动脉血氨升高（+42±3微克/100毫升）与对照试验中观察到的无差异；但静脉血氨血症的升高较低（+12±4微克/100毫升；p<0.01），动脉-静脉血氨差值显著增加。这些结果表明，口服葡萄糖通过一种尚待阐明的机制增加外周肌肉对氨的摄取，但该机制对动脉高氨血症无效。
