Sakai K, Ouchi K, Sato R, Oguma S, Matsuno S
First Department of Surgery, Tohoku University School of Medicine, Sendai, Japan.
Nihon Geka Gakkai Zasshi. 1993 Jan;94(1):50-6.
We evaluated experimentally the effect of administration of glucose on hepatic energy metabolism, mitochondrial functions and lipid metabolism after hepatic resection. The 75% hepatic resection was performed on thioacetamide induced cirrhotic rat. Glucose solution with 30 Cal/kg/day (group I) or 200 Cal/kg/day (group II) was administrated intravenously for 48 hours after hepatic resection. Blood levels of ketone bodies and glucagon, tissue activities of ATP synthesis and tissue content of adenine nucleotides were measured in both groups. Hepatic energy charge was significantly decreased in group II, comparing with group I. When fatty acid was used as a substrate for respiratory system, the activity of ATP synthesis on mitochondria after hepatic resection rose, while in case pyruvate was used as a substrate the value was declined. On the levels of serum free fatty acids and ketone bodies, there were no remarkable changes in group I, while in group II, obvious declines were investigated. It is suggested that the overload of glucose in the early stage after hepatic resection is unfavorable to hepatic energy metabolism because of decline of serum free fatty acid by hyperinsulinemia and suppression of fatty acid oxidation by decline of blood glucagon.
我们通过实验评估了肝切除术后给予葡萄糖对肝脏能量代谢、线粒体功能和脂质代谢的影响。对硫代乙酰胺诱导的肝硬化大鼠进行75%肝切除术。肝切除术后48小时，分别以30千卡/千克/天（I组）或200千卡/千克/天（II组）的葡萄糖溶液静脉给药。测量两组的酮体和胰高血糖素血水平、ATP合成的组织活性以及腺嘌呤核苷酸的组织含量。与I组相比，II组的肝脏能荷显著降低。当脂肪酸用作呼吸系统的底物时，肝切除术后线粒体上ATP合成的活性升高，而当丙酮酸用作底物时，该值下降。I组血清游离脂肪酸和酮体水平无明显变化，而II组则明显下降。提示肝切除术后早期葡萄糖负荷过重不利于肝脏能量代谢，原因是高胰岛素血症导致血清游离脂肪酸下降以及血胰高血糖素下降抑制脂肪酸氧化。
