Pezzarossa A, Contini S, Scarpignato C, Bairamian M, Coiro V, Butturini U
J Endocrinol Invest. 1984 Jun;7(3):201-5. doi: 10.1007/BF03348423.
Plasma levels and renal uptake of gastrin were determined in ten dogs submitted to complete liver devascularization in order to induce an acute liver failure. Renal function was evaluated by renal plasma flow (RPF) and glomerular filtration rate (GFR) determinations. Liver devascularization was obtained by end-to-side porto-caval shunt (PCS) followed by temporary clamping of the hepatic artery. PCS alone did not affect renal function and renal ability to remove gastrin; after hepatic ischemia, both RPF, GFR and renal extraction of gastrin showed an abrupt decrease. At the end of the period of hepatic ischemia 5 dogs were submitted to glucose infusion, in consideration that: i) glucagon is able both to affect gastrin release and renal hemodynamics, and ii) hypoglycemia that develops after liver failure releases elevated amounts of glucagon. The renal handling of gastrin was not related to glucagon plasma levels, though the higher gastrin levels occurred at the lower glucagon concentrations. These data suggest that in acute liver failure there is a striking decrease of the renal clearance of gastrin associated with the impairment of kidney function. Furthermore, in this pathological condition plasma gastrin levels are affected by blood glucose concentrations through its effect on plasma glucagon levels.
为诱导急性肝衰竭，对十只狗进行了完全性肝脏去血管化手术，并测定了其胃泌素的血浆水平和肾脏摄取情况。通过测定肾血浆流量（RPF）和肾小球滤过率（GFR）来评估肾功能。通过端侧门腔分流术（PCS）实现肝脏去血管化，随后临时夹闭肝动脉。单独的PCS并不影响肾功能以及肾脏清除胃泌素的能力；肝脏缺血后，RPF、GFR以及胃泌素的肾脏摄取均出现突然下降。在肝脏缺血期结束时，考虑到：i）胰高血糖素既能影响胃泌素释放，又能影响肾脏血流动力学；ii）肝衰竭后发生的低血糖会释放大量胰高血糖素，对五只狗进行了葡萄糖输注。尽管在较低的胰高血糖素浓度下胃泌素水平较高，但胃泌素的肾脏处理与血浆胰高血糖素水平无关。这些数据表明，在急性肝衰竭时，胃泌素的肾脏清除率显著下降，且与肾功能损害相关。此外，在这种病理状态下，血浆胃泌素水平受血糖浓度影响，血糖通过其对血浆胰高血糖素水平的作用来影响胃泌素水平。
