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静脉输注高渗葡萄糖溶液对胰腺HCO3(-)分泌的影响。

Effect of intravenous infusion of hypertonic glucose solutions on pancreatic HCO3(-) secretion.

作者信息

Raeder M, Mathisen O

出版信息

Acta Physiol Scand. 1982 Jul;115(3):349-54. doi: 10.1111/j.1748-1716.1982.tb07088.x.

Abstract

To examine why intravenous infusion of hypertonic non-electrolyte solutions inhibit pancreatic HCO3(-) secretion, the relationship between pancreatic HCO3(-) secretion and plasma pH was examined before and following intravenous infusion of hypertonic glucose to 5 anesthetized, secretin infused (2.7 C.U./kg b.wt.h-1) pigs. Hyperglycemia (plasma glucose 103 +/- 6 mmol/l) did not significantly change plasma pH, Na+, K+, Cl- and HCO3(-) concentrations. Hyperglycemia reduced pancreatic water flux by 48 +/- 5% and raised pancreatic juice HCO3(-) concentration by 43 +/- 4 mmol/l. Concurrently, HCO3(-) secretion fell by 34 +/- 5%. Acidosis, produced through intravenous HCl infusion and CO2 addition to inspired air, reduced HCO3(-) secretion by 40 +/- 6 mumol/min and 30 +/- 5 mumol/min per 0.1 pH unit reduction in plasma pH before and during hyperglycemia, respectively, and abolished HCO3(-) secretion at an estimated plasma pH of 6.51 +/- 0.06 before and a pH of 6.63 +/- 0.05 during hyperglycemia. We conclude that hypertonic glucose infusions inhibit pancreatic water flux and cause an increase in pancreatic juice HCO3(-) concentration which may inhibit HCO3(-) secretion through an effect on acid-base balance in secretory cells.

摘要

为了探究静脉输注高渗非电解质溶液为何会抑制胰腺HCO₃⁻分泌,在对5只麻醉的、输注促胰液素(2.7单位/千克体重·小时⁻¹)的猪静脉输注高渗葡萄糖之前和之后,研究了胰腺HCO₃⁻分泌与血浆pH之间的关系。高血糖(血浆葡萄糖103±6毫摩尔/升)并未显著改变血浆pH、Na⁺、K⁺、Cl⁻和HCO₃⁻浓度。高血糖使胰腺水通量降低48±5%,并使胰液HCO₃⁻浓度升高43±4毫摩尔/升。同时,HCO₃⁻分泌下降了34±5%。通过静脉输注HCl以及向吸入空气中添加CO₂产生的酸中毒,在高血糖之前和期间,分别使血浆pH每降低0.1个单位时HCO₃⁻分泌减少40±6微摩尔/分钟和30±5微摩尔/分钟,并在估计的血浆pH为6.51±0.06(高血糖之前)和6.63±0.05(高血糖期间)时使HCO₃⁻分泌停止。我们得出结论,高渗葡萄糖输注会抑制胰腺水通量,并导致胰液HCO₃⁻浓度升高,这可能通过影响分泌细胞的酸碱平衡来抑制HCO₃⁻分泌。

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