Metabolic abnormalities and grade of encephalopathy in acute hepatic failure.
Metabolic abnormalities and grade of encephalopathy in acute hepatic failure.
复制标题
急性肝衰竭中的代谢异常和脑病分级。
DOI：
10.1046/j.1471-4159.1994.63051829.x
复制
发表时间：
1994
影响因子：
4.7
通讯作者：
Hawkins,RA
中科院分区：
文献类型：
--
作者：
Mans,AM;DeJoseph,MR;Hawkins,RA
急性肝衰竭与血浆和脑中的许多生化异常有关。与行为障碍程度密切相关的变化可能是脑病发展的重要因素。我们测量了急性肝血管离断大鼠脑和血浆中中间代谢物、氨和氨基酸的浓度以及全脑葡萄糖利用率。在所有大鼠中，对脑病的级别进行了估计（通过行为障碍反映）。大鼠接受门腔静脉分流术和肝动脉结扎（或假手术），并保持正常血糖和常温。我们在2、4或6 h后采集血液和全脑样本（通过近瞬时冷冻吹扫）。除乳酸盐和丙酮酸盐外，脑中高能磷酸盐代谢物或与糖酵解途径和克雷布斯循环相关的代谢物水平未发生变化。在手术后的所有时间，脑葡萄糖的使用都类似地减少。脑和血浆中的氨和许多氨基酸水平升高;脑天冬氨酸、谷氨酸和精氨酸水平降低。血浆氨和脑谷氨酰胺，脯氨酸，丙氨酸和芳香族氨基酸含量的增加和脑天冬氨酸和谷氨酸的减少与行为障碍最密切相关。
Acute hepatic failure is associated with many biochemical abnormalities in plasma and brain. Changes that correlate well with the degree of behavioral impairment may be important factors in the development of encephalopathy. We measured the concentrations of intermediary metabolites, ammonia, and amino acids in brain and plasma and the rate of whole‐brain glucose utilization in rats with an acutely devascularized liver. In all rats an estimate of the grade of encephalopathy (reflected by behavioral impairment) was made. Rats underwent portacaval shunting and hepatic artery ligation (or sham operation) and were kept normoglycemic and normothermic thereafter. We sampled blood and whole brain (by near‐instantaneous freeze‐blowing) 2, 4, or 6 h later. There were no alterations in levels of high‐energy phosphate metabolites in the brain or in metabolites associated with the glycolytic pathway and Krebs cycle, except lactate and pyruvate. Brain glucose use was decreased similarly at all times after surgery. Levels of ammonia and many amino acids were increased in brain and plasma; brain aspartate, glutamate, and arginine levels were decreased. The increases in content of plasma ammonia and brain glutamine, proline, alanine, and aromatic amino acids and the decreases in brain aspartate and glutamate were most strongly correlated with behavioral impairment.