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肾上腺静脉结扎或内脏神经切断术后低血糖时的胰岛素分泌

Insulin secretion in hypoglycemia after adrenal vein ligature or splachnicotomy.

作者信息

Sando H, Miki E, Kosaka K

出版信息

Am J Physiol. 1977 Feb;232(2):E237-42. doi: 10.1152/ajpendo.1977.232.2.E237.

Abstract

During bonito insulin-induced hypoglycemia in dogs, pancreatic venous dog insulin concentration (IRI), radioimmunoassayed differentially from bonito insulin, was progressively diminished in response to local glucose infusion (0.6 mg/kg - min) for 4 min into the superior pancreaticoduodenal artery. Basal arterial plasma glucose was significantly lower after bilateral splanchnicotomy (BSNC) than after bilateral adrenal vein ligature (BAVL). During local glucose infusion in both normoglycemia and hypoglycemia, the increment of pancreatic venous IRI was significantly greater after BAVL or BSNC than in the controls, and the increment of pancreatic venous glucose was also significantly greater after BAVL than in the controls or after BSNC. It is suggested that under the stress of major surgery the splanchnic nerves partially suppress insulin secretion in normoglycemia as well as in hypoglycemia, and epinephrine released from the adrenal medulla may interfere with glucose-mediated insulin secretion in profound hypoglycemia.

摘要

在犬鲣鱼胰岛素诱导的低血糖期间,经放射免疫法与鲣鱼胰岛素差异测定的犬胰腺静脉胰岛素浓度(IRI),在向上胰十二指肠动脉局部输注葡萄糖(0.6毫克/千克 - 分钟)4分钟后,随着反应逐渐降低。双侧内脏神经切断术(BSNC)后基础动脉血浆葡萄糖显著低于双侧肾上腺静脉结扎术(BAVL)后。在正常血糖和低血糖状态下局部输注葡萄糖期间,BAVL或BSNC后胰腺静脉IRI的增量显著大于对照组,并且BAVL后胰腺静脉葡萄糖的增量也显著大于对照组或BSNC后。提示在大手术应激下,内脏神经在正常血糖和低血糖状态下均部分抑制胰岛素分泌,并且肾上腺髓质释放的肾上腺素可能在严重低血糖时干扰葡萄糖介导的胰岛素分泌。

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