手術侵襲後における二糖類maltoseの代謝に関する研究

第一編動物実験的研究

抄録

Correct and adequate nutrition of the surgical patient is a most important therapeutic measure for obtaining good convalescence. In catabolic conditions a sufficient caloric supply without the risk of overloading the patient is required to diminish the negativity of the nitrogen balance. The most important sugar source in parenteral nutrition is glucose. There do exist, however, condition with an impaired glucose utilization, such as postoperative catabolism, in which insulin independent sugars should be preferred instead of glucose for parenteral nutrition.
Since the parenteral use of maltose as a carbohydrate was first reported by Weser et al., an additional information on the clinical value of parenterally administered maltose has been provided by Japanese investigators. This study was undertaken to evaluate the effect of a surgical stress on the utilization of various sugars in experimental animals by the use of ¹⁴C-labeled sugars.
Male guinea pigs, after exposure to surgical stress, were given an intraperitoneal injection of maltose-U-¹⁴C or glucose-U-¹⁴C. The operated and non-operated animals were compared as to their utilization of the labeled sugars by the measurement of expired ¹⁴CO₂. Experiments were divided into A and B. In experiment A, immediately after operation, the animals received uniformely labeled (l4C) sugars. Experiment B animals received uniformely labeled (l4C) sugars at 24 hours after operation.
The following results were obtained: In both experiment A and B, peak ¹⁴CO₂ excretion was attained at 2 hours for the glucose-injected animals and at 3 hours for the maltose-injected ones. In experiment A the non-operated control group injected with the sugars after a 24 hours starvation, the recovery rate of the expired ¹⁴CO₂ during 8 hours was higher in the glucose-injected animals than in the maltose-injected ones. In the operated group, however, the maltose-injected ones showed a higher recovery rate than the glucose-injected ones. Comparison between the operated groups and non-operated groups in the cumulative recovery rate at 8 hours revealed that the operation produced a difference of only 7.8% for the maltose-injected animals as contrasted with 25.1% for the glucose-injected ones. In experiment B, the recovery rate of expired "CO2 showed similar tendencies to that of experiment A. The differences in the recovery rate between the operated groups and control groups were 10.9% for the glucose-injected and 3.8% for the maltose-injected groups.