文摘

为了研究动脉内脏交换基质浓度和激素患者的慢性炎症性肠病3例克罗恩病和溃疡性结肠炎患者四个使用肝静脉导管技术进行了研究。系统性的营业额和地区交流游离脂肪酸进行评估使用静脉输液14 c-labelled油酸。所有测量都在postabsorptive,通宵禁食状态。动脉在患者葡萄糖浓度下降了10%,但净内脏葡萄糖输出类似于病人和控制。葡萄糖前体吸收(乳酸、丙酮酸和甘油),然而,增加2到5折的病人。动脉氨基酸浓度通常是减少但净内脏氨基酸吸收相同的病人和控制。动脉游离脂肪酸和油酸的浓度以及系统性和部分营业额相似的病人和控制。病人的内脏吸收油酸与控制相比增加了三倍多。内脏释放油酸也增强病人。动脉浓度和内脏的酮体的生产都在病人。 The proportion of splanchnic free fatty acid uptake which could be accounted for by ketone body production was significantly greater in the patients (37 +/- 4%) than the controls (20 +/- 5%, p less than 0.025). Estimated hepatic blood flow was 55% greater (p less than 0.01) in the patients as compared with the controls (1930 +/- 150 vs 1240 +/- 70 ml/min), while splanchnic oxygen uptake was similar in the two groups. From these findings it is concluded that patients with chronic inflammatory bowel disease show (1) markedly increased hepatic blood flow, reflecting an inflammatory hyperaemia in the splanchnic region, (2) a normal net splanchnic glucose output, (3) accelerated hepatic gluconeogenesis as well as ketogenesis, probably as a consequence of the altered hormonal milieau, and (4) low concentrations of most amino acids possibly because of protein malabsorption. These findings underscore the importance of adequate protein and carbohydrate administration to this patient group.