正常肝, 硬変肝広範切除後の糖処理能に関する実験的検討

概要

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In order to determine the adequate amount of glucose administration after hepatic resection, IVGTT and ITT were performed at 1, 2, 3 and 7 postoperative days (POD) in normal and thioacetamide-induced cirrhotic rats subjected to 70% hepatectomy and the glucose disposal rate (GDR) was evaluated. Prospected values of GDR were calculated with the analytic index of IVGTT and ITT. Subsequently, those were compared with values measured by the hyperglycemic glucose clamp method. The following results were obtained: 1) Prospected values of GDR were closely similar to the measured values, indicating that it is possible to obtain the GDR value by means of simple and convenient measure. 2) GDR in cirrhotic rats which was lower than that in control rats decreased at 1 POD and then recovered to the level of preoperative values at 3POD. 3) An increase of GDR was not observed after resection of cirrhotic livers even with maximum doses of insulin infusion. These results suggest that adequate amount of glucose must be administered in the early postoperative period after resection of cirrhotic livers, because glucose utilization is significantly decreased mainly due to insulin resistance.
社団法人日本肝臓学会の論文