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大剂量腹腔注射胰岛素的药代动力学(作者译)

[Pharmacokinetics of insulin administered intraperitoneal in a bolus form (author's transl)].

作者信息

Bottermann P, Gyaram H, Wahl K, Ermler R, Lebender A

出版信息

Klin Wochenschr. 1981 Feb 16;59(4):157-63. doi: 10.1007/BF01477475.

Abstract

Although carbohydrate-intake and subcutaneous insulin injection in the insulin dependent diabetics are brought to match with one another, there is often an incongruity between the momentary insulin need and the actual insulin supply, because insulin is resorbed relatively slow from the subcutaneous injection site. While the plasma insulin concentration in healthy persons after carbohydrate-intake reaches its maximum after ca. 45 min, the maximum insulin concentration after subcutaneous application of regular insulin is observed only after ca. 2 h. For this reason, we studied whether a faster rise in the insulin concentration can be obtained by intraperitoneal bolus application of insulin. 5 metabolic healthy volunteers received 20 UI regular insulin diluted in isotonic saline solution injected intraperitoneal. The insulin concentration in the peripherovenous system was examined. In order to prevent severe hypoglycaemia the test persons were connected to a Biostator (so-called artificial Beta-cell), which delivered glucose automatically when the blood glucose concentration fell below the 60 mg/dl - level, and thus avoided a drastic fall of the blood glucose. A rapid increase in the plasma insulin concentration was observed within a few minutes after the intraperitoneal bolus injection of insulin. After ca. 20 min the maximal insulin concentration was reached. Already after ca. 2 h the plasma insulin levels fell off and approached the initial values. Consequently, the changes of insulin concentration after intraperitoneal bolus application of insulin correspond widely to the insulin curve characteristic of metabolic healthy persons after carbohydrate-intake. Thus, the intraperitoneal bolus injection of insulin presents a mode of application, which must be pursued further in the treatment of insulin dependent diabetics.

摘要

虽然胰岛素依赖型糖尿病患者的碳水化合物摄入量与皮下胰岛素注射量相互匹配,但由于胰岛素从皮下注射部位的吸收相对缓慢,瞬时胰岛素需求与实际胰岛素供应之间往往存在不协调。健康人摄入碳水化合物后,血浆胰岛素浓度约在45分钟后达到最大值,而皮下注射普通胰岛素后,最大胰岛素浓度仅在约2小时后才出现。因此,我们研究了通过腹腔推注胰岛素是否能更快地提高胰岛素浓度。5名代谢健康的志愿者接受了腹腔注射20单位稀释于等渗盐溶液中的普通胰岛素。检测外周静脉系统中的胰岛素浓度。为防止严重低血糖,受试人员连接到一个生物调节器(所谓的人工β细胞),当血糖浓度降至60mg/dl水平以下时,该调节器会自动输送葡萄糖,从而避免血糖急剧下降。腹腔推注胰岛素后几分钟内,血浆胰岛素浓度迅速升高。约20分钟后达到最大胰岛素浓度。约2小时后,血浆胰岛素水平就开始下降并接近初始值。因此,腹腔推注胰岛素后胰岛素浓度的变化与代谢健康者摄入碳水化合物后典型的胰岛素曲线广泛对应。因此,腹腔推注胰岛素是一种给药方式,在胰岛素依赖型糖尿病的治疗中必须进一步探索。

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