肝予備能検査法としての Glucagon 負荷による血中 cyclic AMPの反応性

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It is well established that glucagon brings about elevation in plasma cyclic AMP (c-AMP) and stimulates glycolysis and gluconeogenesis in the liver which is a target organ of the hormone. The present study was undertaken to explore whether or not responses of both plasma c-AMP and glucose to intravenous injection of glucagon (1mg) become useful indicators to estimate hepatic reserve. In comparison with normal subjects, marked reductions in plasma c-AMP and glucose responses were observed in liver cirrhosis (8 cases) and none of the responses found in fulminant hepatitis (2 cases). On the other hand, patients with intrahepatic cholestasis (3 cases) revealed hyper-responders. In addition, significant correlations between the responses and liver function tests (i.e., hepaplastin test, choline esterase, ICG R15 and KICG) were observed in 6 normal subjects and 15 patients with various hepatobiliary disorders.These results strongly suggest that the responses of both plasma c-AMP and glucose to exogenous glucagon are of practical importance for evaluation of severity of hepatocellular damage as well as of clinical indication of glucagon-insulin therapy in fulminant hepatic failure. Further clinical and experimental data obtained in this study indicate that the reduction in response to exogenous glucagon may due to decrease of AT levels in the liver tissue and/or reduced binding capacity of glucagon receptor on the liver cell membrane under a continuous hyperglucagonemia in severe hepatic damage.
財団法人日本消化器病学会の論文

肝予備能検査法としての Glucagon 負荷による血中 cyclic AMPの反応性

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