Kuroda T, Kajikawa S, Haba Y, Shiohara E, Hanazaki K, Iida F
Department of Surgery, Shinshu University School of Medicine, Matsumoto, Japan.
Pancreas. 1993 Mar;8(2):267-72. doi: 10.1097/00006676-199303000-00020.
Insulin and glucagon metabolism in the pancreas with obstructive jaundice caused by complete ligation of the common bile duct and in the cholestatic liver caused by hepatic duct ligation was evaluated experimentally using dogs. The isolated perfused pancreas in obstructive jaundiced dogs, which showed a low insulin response in the peripheral blood after intravenous glucose administration, revealed depression of insulin production and no change of glucagon production in response to cholecystokinin octapeptide. The extraction of insulin in the cholestatic lobe of the liver was decreased compared with that in the noncholestatic lobe. The extraction of glucagon, on the other hand, in the cholestatic lobe and in the noncholestatic lobe showed no significant difference. So the imbalance of glucose metabolism in obstructive jaundice does not depend on the enhanced extraction of insulin in the liver, but on the depression of insulin production in the pancreas.
采用犬实验性评估了胆总管完全结扎所致梗阻性黄疸时胰腺中的胰岛素和胰高血糖素代谢,以及肝管结扎所致胆汁淤积性肝脏中的胰岛素和胰高血糖素代谢。梗阻性黄疸犬的离体灌注胰腺在静脉注射葡萄糖后外周血胰岛素反应较低,其胰岛素生成受抑制,对八肽胆囊收缩素的反应中胰高血糖素生成无变化。与非胆汁淤积叶相比,胆汁淤积叶肝脏中胰岛素的摄取减少。另一方面,胆汁淤积叶和非胆汁淤积叶中胰高血糖素的摄取无显著差异。因此,梗阻性黄疸时糖代谢失衡并非取决于肝脏中胰岛素摄取增加,而是取决于胰腺中胰岛素生成受抑制。