Yokota H, Kawashima Y, Takao T, Hashimoto S, Manabe H
J Thorac Cardiovasc Surg. 1977 Apr;73(4):543-9.
Carbohydrate and lipid metabolism was studied in 8 patients who underwent open-heart surgery with the aid of extracorporeal circulation. Hyperglycemia was observed during perfusion. Despite the high glucose levels during perfusion, insulin responses were depressed. A rise of insulin levels was observed one hour after perfusion, and at the same time the glucose levels dropped. Suppression of insulin secretion during perfusion may be the result of increased catecholamine secretion, induced hypothermia, or heparin administration. High levels of non-esterified fatty acids (NEFA) and low levels of triglycerides were observed immediately before, during, and after perfusion while heparin was being utilized. This phenomenon was considered to be strongly affected by the use of heparin. The levels of growth hormone were depressed during perfusion but significantly elevated one hour after the end of perfusion. These phenomena may be caused by the fluctuations in glucose and NEFA levels.
对8例在体外循环辅助下接受心脏直视手术的患者进行了碳水化合物和脂质代谢研究。灌注期间观察到高血糖。尽管灌注期间血糖水平很高，但胰岛素反应受到抑制。灌注后1小时观察到胰岛素水平升高，同时血糖水平下降。灌注期间胰岛素分泌受抑制可能是儿茶酚胺分泌增加、诱导性低温或肝素给药所致。在使用肝素期间，灌注前、灌注期间和灌注后立即观察到高水平的非酯化脂肪酸（NEFA）和低水平的甘油三酯。这种现象被认为受肝素使用的强烈影响。灌注期间生长激素水平降低，但灌注结束后1小时显著升高。这些现象可能是由葡萄糖和NEFA水平的波动引起的。
