Andreen M, Brandt R, Strandell T, Vinnars E, Zetterström B E
Acta Anaesthesiol Scand. 1981 Dec;25(6):453-60. doi: 10.1111/j.1399-6576.1981.tb01686.x.
It is known that hepatic gluconeogenesis from lactate and aminoacids is inhibited by halothane in in vitro studies on isolated, perfused livers. In the present work, the effect of halothane anaesthesia on hepatic gluconeogenesis was studied in three volunteers during a constant amino-acid infusion and compared with three control subjects who did not receive any halothane during the amino-acid infusion. Prior to the investigation, all the subjects were on a carbohydrate-poor diet in order to deplete hepatic glucogen stores. During the investigation, hepatic gluconeogenesis was stimulated by a constant amino-acid infusion which caused a slight rise in total hepatic blood flow (THBF), a marked increase in splanchnic oxygen consumption and oxygen extraction, elevation in blood glucose and urea levels and in splanchnic glucose and urea releases. Halothane anaesthesia administered during continued amino-acid infusion caused a reduction in THBF to sub-control values, while the increased oxygen consumption was only slightly reduced, thereby further increasing splanchnic oxygen extraction. Blood glucose and urea levels of the anaesthetized subjects were consistent with those of the control subjects. Splanchnic release of glucose was reduced almost to control values during halothane. However, the release of urea was only slightly reduced. It is concluded that the stimulating effect on hepatic gluconeogenesis caused by the amino-acid infusion was inhibited during halothane anaesthesia, while metabolization of the amino-acids, other than through gluconeogenesis, proceeded without any major changes.
在对离体灌注肝脏的体外研究中,已知氟烷可抑制肝脏从乳酸和氨基酸进行糖异生。在本研究中,对三名志愿者在持续输注氨基酸期间氟烷麻醉对肝脏糖异生的影响进行了研究,并与三名在输注氨基酸期间未接受任何氟烷的对照受试者进行了比较。在研究之前,所有受试者均采用低糖饮食,以耗尽肝脏糖原储备。在研究过程中,持续输注氨基酸刺激肝脏糖异生,导致肝脏总血流量(THBF)略有增加、内脏氧耗和氧摄取显著增加、血糖和尿素水平升高以及内脏葡萄糖和尿素释放增加。在持续输注氨基酸期间给予氟烷麻醉导致THBF降至低于对照值,而增加的氧耗仅略有降低,从而进一步增加了内脏氧摄取。麻醉受试者的血糖和尿素水平与对照受试者一致。在氟烷作用期间,内脏葡萄糖释放几乎降至对照值。然而,尿素释放仅略有减少。结论是,在氟烷麻醉期间,氨基酸输注对肝脏糖异生的刺激作用受到抑制,而氨基酸除通过糖异生之外的代谢过程没有任何重大变化。