犬肝流入血行遮断時の酢酸加リンゲル液の代謝効果

1）帝京大学医学部（〒173-8605　東京都板橋区加賀2-11-1） 2）麻布大学獣医学部（〒229-8501　相模原市淵野辺1-17-71） 3）関西医科大学（〒570-8507　守口市文園町10-15）

（1999年10月27日受付・2000年2月14日受理）

要　　　　　約 　乳酸加リンゲル液（LR）と酢酸加リンゲル液（AR）を，犬肝流入血行遮断時に投与し，40分間肝虚血と再灌流30分後の影響を検討した．LR群では虚血と再灌流により嫌気的代謝とアシドーシスが進行したが，AR群では有意差はないものの改善傾向がみられ，肝臓以外の組織でも代謝されうるARがアルカリ化剤として機能したと考えられた．ケトン体の動脈血濃度はLR群では肝虚血で激減し動静脈較差もなくなったが，AR群では動脈血ケトン体濃度は低下せず，較差も維持されて末梢組織でケトン体が利用されていることを示した．また，AR群では腎静脈血ケトン体濃度が動脈血濃度を上回り，腎臓でのケトン体産生の可能性を示した．再灌流30分後の肝臓1g当たりのATP＋1/2ADPはAR群が有意に高値で，ARによる末梢組織での代謝改善が，再灌流後の肝臓への負荷を軽減したと推測でき，肝虚血時の輸液剤としてARが有用と考えられた． ―キーワード：犬，エネルギー代謝，肝虚血，ケトン体，酢酸加リンゲル液． --------------------日獣会誌　53，463〜468（2000） Metabolic Effects of Ringer's Acetate Solution During Hepatic Inflow Occlusion in the Dog Yoshimasa SAKAMOTO*, Hirofumi ANDO, Kunio KOBAYASHI, Hiroharu MATSUSHITA,Tatsuo SUZUKI, Yoshihiko SUZUKI and Toshio NAKATANI *Division of Animal Care, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi, Tokyo 173-8605, Japan SUMMARY   We compared the effects of infusions of Ringer's lactate (LR) and acetate (AR) solutions, on acid-base balance and hepatic energy metabolism during 40 min of hepatic inflow occlusion and 30 min of reperfusion in dogs. A slightly milder acidosis was observed in the group receiving AR, compared with the group receiving LR. After 40 min of occlusions in the LR group, ketone body concentrations in arterial and venous blood markedly decreased to a comparable level, indicating no uptake of ketone bodies in peripheral tissues. In contrast, in the group given AR, ketone body concentrations did not decrease during the inflow occlusion. Both the arterial concentration and arterio-venous concentration gradients were maintained, indicating sufficient supply and utilization of ketone bodies in the peripheral tissues. Moreover, the renal-venous concentration of ketone bodies was slightly higher than the arterial concentration, indicating renal ketogenesis during hepatic inflow occlusion in dogs receiving AR infusions. The hepatic energy levels (ATP+1/2ADP) in the AR group were significantly higher than in the LR group after 30 min of reperfusion. Due to the improved acid-base balance and sufficient ketone body supply to peripheral tissues, the metabolic burden of the liver after release of occlusion was considered to be smaller in the AR group. AR administration during hepatic ischemia is recommended. ―Key words : dog, energy metabolism, hepatic ischemia, ketone bodies, Ringer's acetate. --------------------J. Jpn. Vet. Med. Assoc., 53, 463〜468 (2000)