Stevenson R W, Parsons J A, Alberti K G
Clin Endocrinol (Oxf). 1978 Apr;8(4):335-47. doi: 10.1111/j.1365-2265.1978.tb02776.x.
Changes in glucose, phosphate, potassium, non-esterified fatty acids (NEFA) and insulin in peripheral venous blood were compared in five unrestrained fasted dogs during different rates of insulin infusion by the portal and peripheral circulation. The 'low' rate of insulin infusion was that required to produce a fall in plasma glucose of 0.56-0.83 mmol/l (0.024 u/kg/h female, 0.012 u/kg/h male). Two-fold and four-fold higher rates are referred to as 'medium' and 'high' rates, respectively. In all dogs, dose-related reductions in the glucose concentration of peripheral blood resulted from increasing the rate of insulin by either route. At 'low' and 'high' rates of infusion the net response was independent of the route of administration, but the 'medium' rate of insulin infusion led to a greater degree of hypoglycaemia when given peripherally than intraportally. As expected, insulin infused peripherally resulted in graded increases in peripheral insulin levels as the rate of infusion was increased from low to high while, paradoxically, intraportal administration at low and medium infusion rates resulted in a mean decrease of peripheral insulin levels from control, the low-dose producing the most consistent fall. The fact that hypoglycaemia accompanied this fall during portal infusion suggests that these low doses of insulin had a direct effect on plasma phosphate resulting from the change in route of administration of insulin (i.e. increase during portal and decrease during peripheral infusion) also suggests a direct hepatic effect of insulin given intraportally.
在五只未受限制的禁食犬中,通过门静脉和外周循环以不同速率输注胰岛素,比较外周静脉血中葡萄糖、磷酸盐、钾、非酯化脂肪酸(NEFA)和胰岛素的变化。胰岛素输注的“低”速率是指能使血浆葡萄糖下降0.56 - 0.83 mmol/l所需的速率(雌性为0.024 u/kg/h,雄性为0.012 u/kg/h)。两倍和四倍高的速率分别称为“中”和“高”速率。在所有犬中,通过任何一种途径增加胰岛素输注速率都会导致外周血葡萄糖浓度呈剂量依赖性降低。在“低”和“高”输注速率下,净反应与给药途径无关,但外周输注胰岛素的“中”速率比门静脉内输注导致更严重的低血糖。正如预期的那样,随着输注速率从低到高增加,外周输注胰岛素导致外周胰岛素水平逐渐升高,而矛盾的是,在低和中输注速率下门静脉内给药导致外周胰岛素水平相对于对照平均下降,低剂量导致的下降最为一致。门静脉输注期间低血糖伴随这种下降这一事实表明,这些低剂量胰岛素对血浆磷酸盐有直接影响,胰岛素给药途径的改变导致的血浆磷酸盐变化(即门静脉输注时升高,外周输注时降低)也表明门静脉内给予胰岛素有直接的肝脏效应。