アブストラクト（55巻1号：神奈川歯学）

神奈川歯学

Japanese

Title　： 幼児における周術期の糖の投与と代謝に関する研究
Subtitle　： 原著
Authors　： 衣川智子, 森本佳成, 林恵美, 飯田貴俊
Authors（kana）　：
Organization　： 神奈川歯科大学大学院歯学研究科全身管理医歯学講座
Journal　： 神奈川歯学
Volume　： 55
Number　： 1
Page　： 68-75
Year/Month　： 2020 / 6
Article　： 原著
Publisher　： 神奈川歯科大学学会
Abstract　： 「緒言」生理的状況下では, グルコースと脂肪酸は, 生体の主なエネルギー源である. 飢餓時や運動時には, 貯蔵されたグリコーゲンが動員され, 代謝されてグルコースを生成する(糖新生). さらに肝臓では脂肪分解が促進され, 主に脂肪酸のβ-酸化によってケトン体(アセト酢酸またはβ-ヒドロキシ酪酸)が生成される. 生成されたケトン体は, 脳や末梢組織で利用されるエネルギー源となる. しかし, ケトン体濃度が過剰に上昇すると, ケトアシドーシスをきたし非生理的状態に陥る. 術前の絶飲食ガイドラインでは, 「軽食は麻酔導入8時間前まで, 清澄水の摂取は2時間前まで安全である. 」とされている. これは, 長時間の絶飲食と比較して胃内容液量は不変かあるいは減少し, 胃内容液pHはすべての研究において変わらないことから, 誤嚥の危険性は増加しないからである.
Practice　： 歯科学
Keywords　： 代謝, 異化, 糖, 幼児

English

Title　： Study of the glucose administration and metabolism in infants during perioperative period
Subtitle　：
Authors　： Tomoko KINUGAWA, Yoshinari MORIMOTO, Megumi HAYASHI, Takatoshi IIDA
Authors（kana）　：
Organization　： Department of Critical Care Medicine and Dentistry, Graduate School of Dentistry, Kanagawa Dental University
Journal　： Kanagawa Shigaku
Volume　： 55
Number　： 1
Page　： 68-75
Year/Month　： 2020 / 6
Article　： Original article
Publisher　： Kanagawa Odontological Society
Abstract　： [Abstract] The purpose of the present study was to investigate the catabolism, nutritional parameters, and adipocytokine in infants who had preoperative liquid intake followed by glucose administration to them during general anesthesia to avoid the hyperketonemia resulting from lipid catabolism. The subjects were 3 healthy infants (1 male and 2 females) aged from 13 months to 50 months. For preoperative liquid intake, the infants were allowed to drink formula for 6 hours before entering the operating room and 6.2% glucose solution for 2 hours before entering the operating room. As an intraoperative infusion, 156 mg/kg/hour of glucose was constantly administered. The levels of serum ketone bodies, free fatty acid, glucose, retinol binding protein and leptin were measured on anesthesia induction (M1) and 1.5 hours after the induction of anesthesia (M2). The body impedance analysis (BIA) measurement were also performed on the previous day (standard value), on M1 and on M2. The resting metabolic rate and total body water values measured by BIA did not differ between at preoperative and at M1 measurements, but both parameters elevated slightly at M2. Although the ketone body concentrations were around the upper limit of standard value at M1 measurement, extreme high concentrations were observed at M2 (426 - 1824 μmol/L). The free fatty acid concentrations (0.87 - 1.35mE/L) and blood glucose values (151 - 200 mg/dL) also elevated at M2 measurement. The retinol binding protein concentrations were under the lower limit of standard value (1.5 - 1.9 mg/dl), and the values of leptin were distributed in the wide range (2.5 - 8.1 mg/mL) at M1. Even the adequate volume of glucose was administered intraoperatively, catabolism was progressed in infants. The new strategies of glucose administration in infants during perioperative period should be established for suppressing catabolism.
Practice　： Dentistry
Keywords　：