摘要
我们对烧伤家兔胃内注入甲苯磺丁脲后持续观察10天,结果提示甲苯磺丁脲能通过下列作用改善烧伤后高代谢:(1)刺激胰岛素分泌,强化胰岛素作用;(2)改善组织胰岛素抵抗,促进葡萄糖利用;(3)抑制胰高糖素分泌。
Comparatively low level of serum insulin and tissue insulin resistance are characterictic of the stage of burn hypermetabolism.In order to evaluate the effect of tolbutamide in reducing burn hypermetabolism rate,18 adult male rabbits weighing 1.8-2.5 Kg were subjected to 30% TBSA full thickness burns and randomized into treated and control groups.In the treated group,tolbutamide(90mg/Kg/day)was introduced into the stomach from 4 hours to 10 days postburn.Animals of both group were fed with specified food (protein 15%,glucose 80%)after burn.The values of serum glucose,insulin,glucagon, oxygen expenditure and other nutritional indices were measured before burs and 1,3,6,10 days postburn.Their changes were as follows: (1)Serum glucose levels of the treated group were obviously lower than those of the control group(P<0.01). (2)Serum insulin levels and the ratio of I/G(insulin/glucagon)of the treated group were significantly higher than those of the control group(P<0.01). (3)The indices of cumulative N balance,oxygen expenditure,serum albumin in the treated group were better than that in the control(P<0.05-0.001). It is concluded that tolbutamide can reduce burn hypermetabolism probably through the following ways:①stimulation of the secretion of insulin and enhancement of the effect of insulin;②inhibition of the secretion of glucagon;③improvement in tissue insulin resistance and promotion of glucose utilization of skeletal muscles.
