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Metabolic and Nutritional Management after Total Pancreatectomy and Study on Nasal Absorption of Glucagon.

全胰腺切除术后的代谢和营养管理以及胰高血糖素鼻吸收的研究。

基本信息

批准号：
01570761
负责人：
IKEI Satoshi
金额：
$ 1.02万
依托单位：
Kumamoto University
依托单位国家：
日本
项目类别：
Grant-in-Aid for General Scientific Research (C)
财政年份：
1989
资助国家：
日本
起止时间：
1989 至 1990
项目状态：
已结题

项目摘要

The management in which both insuli and glucagon in addition to insulin alone resulted in fairly stable blood glucose control with the administration of an adequate level of energy in total pancreatectomized patients. This method should thus promote both recovery from postoperative stress and healing of the surgical wound. The effects of exogenous glucagon on a totally pancreatectomized patient were evaluated in both the acute postoperative and convalescent periods.In the acute postoperative phase, glucagon stabilized the blood glucose level and allowed the administration of an adequate amount of energy, while during the convalescent period, it proved useful in promoting the metabolism of lipids and amino acids and maintaining liver function. Moreover, we developed a glucagon aerosol which enabled frequent administration without causing major discomfort to the patient and raised the blood glucagon to satisfactory level.Thus, liver function and the metabolism of carbohydrates, lipids, a … More nd amino acids improved with the administration of glucagon. However, because the duration of the action of glucagon is so short. daily administration only results in the reappearance of metabolic disturbances. It is therefore necessary to develop a long acting glucagon preparation or a method for frequent administration that dose not cause discomfort to the patient. The use of a nasal spray resulted in a decrease in the absorption of glucagon to less than one-third of the same dose given subcutaneously, moreover, the amount absorbed intranasally can vary. In insulin administration regulation of the amount absorbed is needed due to the long duration of action. Whereas, because this is not needed for glucagon due to its short duration of action, a nasal spray is suitable.Nasal absorption of glucagon in rats was enhanced by addition of sodium glycyrrhetinate (GA Na), dipotassium glycyrrhizinate (GZ K_2), and carbeboxolone (glycyrrhetinic acid hydrogen succinate) disodium salt (GAHS Na_2). The latter agent was the most effective. GAHS Na_2 is a very useful promoter which dose not irritate the nasal mucosal membrane or degrade glucagon. Less

在全胰腺切除患者中，除了单独使用胰岛素外，还使用胰岛素和胰高血糖素的管理导致血糖控制相当稳定，并给予足够的能量水平。因此，这种方法应促进术后应激的恢复和手术伤口的愈合。本文报告了胰全切除术后急性期和恢复期应用外源性胰高血糖素的效果，在急性期，胰高血糖素能稳定血糖，提供足够的能量;在恢复期，胰高血糖素能促进脂肪和氨基酸的代谢，维持肝功能。此外，我们开发了一种胰高血糖素气雾剂，可以频繁给药，而不会给患者带来重大不适，并将血胰高血糖素提高到令人满意的水平。因此，肝功能和碳水化合物、脂质、a ...更多信息胰高血糖素的应用改善了氨基酸水平。然而，由于胰高血糖素作用的持续时间很短。每日给药仅导致代谢紊乱的再现。因此，有必要开发一种长效胰高血糖素制剂或一种用于频繁施用而不会引起患者不适的方法。鼻喷雾剂的使用导致胰高血糖素的吸收减少至皮下给药相同剂量的三分之一以下，此外，鼻内吸收的量可以变化。在胰岛素给药中，由于作用持续时间长，需要调节吸收量。胰高血糖素作用时间短，不需要鼻喷雾剂，加甘草次酸钠（GA Na）、甘草酸二钾（GZ K_2）和甘珀酸（甘草次酸琥珀酸氢盐）二钠盐（GAHS Na_2）可促进胰高血糖素在大鼠鼻内的吸收。后者是最有效的。GAHS Na_2是一种非常有用的促进剂，它不刺激鼻粘膜，也不降解胰高血糖素。少