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Brain and Nerve No to Shinkei Volume 35, Issue 2 （February 1983）

Brain and Nerve 脳と神経 35巻2号（1983年2月発行）

Japanese English

原著

実験的脳虚血における血糖値の脳代謝に及ぼす影響 EFFECTS OF HYPO- OR HYPERGLYCEMIA ON BRAIN METABOLISM IN EXPERIMENTAL CEREBRAL ISCHEMIA 中富康夫 ¹ , 藤島正敏 ¹ , 吉田富士雄 ¹ , 井林雪郎 ¹ , 塩川宰 ¹ , 尾前照雄 ¹ Yasuo Nakatomi ¹ , Masatoshi Fujishima ¹ , Fujio Yoshida ¹ , Setsuro Ibayashi ¹ , Osamu Shiokawa ¹ , Teruo Omae ¹ ¹九州大学医学部第2内科 ¹Second Department of Internal Medicine, Faculty of Medicine, Kyushu University pp.161-165

発行日 1983年2月1日 Published Date 1983/2/1

DOI https://doi.org/10.11477/mf.1406205073

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Abstract 文献概要
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　抄録　血糖値の変動が虚血脳における糖代謝に如何なる影響を及ぼすかを検討した。自然発症高血圧ラット（SHR）に生理食塩水，50％ブドウ糖溶液，インスリンをそれぞれ腹腔内に投与して，正常血糖（118±31mg／dl），高血糖（620±84），低血糖（22±8）の3群を作成した。各群について，両側総頸動脈を結紮し虚血1時間後に，脳を凍結下に摘出，テント上組織のグルコース，乳酸，ピルビン酸，アデノシン三燐酸（ATP）を測定した。なお非結紮3群を対照群とした。虚血脳内の乳酸値は，高血糖ラット（9.86±8.39mM／kg）では，正常血糖ラツト（5.94士1.38）に比較して高値を示したが，ATPの低下は前者ではほとんどみられなかつた。一方，低血糖ラツト（1.41±0.65mM／kg）では，正常血糖ラット（2.66±0.35mM／kg）に比して，ATPが有意（p＜0.01）に減少した。これらの結果から，不完全脳虚血時の脳エネルギー代謝が高血糖によつては明らかな影響を受けないが，低血糖では著しく障害されると結論された。

Glucose, lactate, pyruvate and adenosine tripho-sphate (ATP) concentrations in the supratentorial brain tissue frozen in situ were measured one hour after bilateral carotid occlusion in spontaneously hypertensive rats, of which blood glucose levels were varied by intraperitoneally injected insulin (hypoglycemia), saline (normoglycemia) and 50% glucose (hyperglycemia).

Cerebral glucose concentrations as well as blood glucose levels were significantly increased in hy-perglycemic animals, and decreased in hypoglyce-mic ones. Cerebral lactate, and lactate/pyruvate ratio at one-hour ischemia tended to increase in hyperglycemic animals comparing with those in normoglycemic ones, although cerebral ATP le-vels were slightly higher in the former. In hypo-glycemic animals with one-hour ischemia, cere-bral lactate was less increased but ATP was sig-nificantly reduced.

It has been reported that hyperglycemia has vul-nerable effects on brain metabolism of complete cerebral ischemia, presumably due to hyperglyce-mia-induced lactic acidosis of the brain. In incom-plete cerebral ischemia as demonstrated in the pre-sent study, however, ATP concentrations remained at slightly higher level, despite tendency to more increase in lactate in hyperglycemic animals, in-dicating that high blood glucose level might be benefical, rather than vulnerable, to incomplete cerebral ischemia. On the other hand, hypoglyce-mia causes more severe impairment of the brain energy metabolism because of an insufficient sup-ply of substrates to the brain.