摘要
目的：研究大鼠急性脑缺血后血糖变化及其与血浆促肾上腺皮质激素（ＡＣＴＨ）、血浆胰岛素（Ｉｎｓ）含量、肝细胞膜胰岛素受体（ＩｎｓＲ）容量和解离常数（Ｋｄ值）变化间的关系。方法：分别采用放射免疫分析法（ＲＩＡ）、放射受体分析法（ＲＲＡ）测定大鼠大脑中动脉（ＭＣＡ）缺血和再灌注后不同时间点血糖、血浆ＡＣＴＨ和Ｉｎｓ、肝细胞膜ＩｎｓＲ容量和Ｋｄ值。结果：ＭＣＡ缺血后３０分钟至再灌注９６小时血浆ＡＣＴＨ浓度均显著高于术前，血糖变化与ＡＣＴＨ相似，两者间呈显著正相关（ｒ＝０．６７６，Ｐ＜０．０１）；再灌注２４小时后出现持续高胰岛素血症，而肝细胞膜ＩｎｓＲ结合容量却显著降低，Ｋｄ值无显著变化。结论：急性脑缺血再灌注后血糖持续升高与应激密切相关。
Objective:To investigate changes in blood sugar and its relation to plasma adrenocorticotrophic hormone (ACTH) and insulin levels,and capacity and K d of insulin receptor in hepatic cell membrane following acute cerebral ischemia.Methods:Levels of blood sugar,plasma insulin and ACTH were measured by oxidase assay and radioimmunoassay respectively,the capacity and K d of insulin receptor on liver cell membrane was determined by radioreceptor assay at different time points after middle cerebral artery (MCA) ischemic reperfusion.Results:It was revealed that the plasma ACTH level increased significantly at 30 minutes after MCA occlusion compared with that before baseline values;they reached the peak at 6 hours,being kept at high values even at 96 hours after reperfusion ( P <0 05).Meanwhile,blood sugar level markedly increased at 1 hour after MCA occlusion, and it was closely correlated with ACTH level ( r =0 676, P <0 01).On the other hand,inhibited secretion of plasma insulin and increased capacity of insulin receptor on liver cell membrane were observed during early ischemia,and while insulin concentration recovered rapidly,persistent hyperinsulinemia was observed at 24 hours.The capacity of insulin receptor reduced markedly and didn′t recover until 48 hours after reperfusion.Conclusions:Insulin resistance may play an important role in the development of persistent hyperglycemia,which appears to be closely related to stress response in acute ischemic reperfusion.
出处
《中国危重病急救医学》
CAS
CSCD
1999年第3期135-137,共3页
Chinese Critical Care Medicine
关键词
脑缺血
血糖
胰岛素抵抗
ACTH
cerebral ischemia\ \ blood sugar\ \ insulin resistance\ \ adrenocorticotrophic hormone
