[Tolbutamide and burn hypermetabolism].
Comparatively low level of serum insulin and tissue insulin resistance are characteristic 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 burn 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 less than 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 less than 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 less than 0.05-0.001). It is concluded that tolbutamide can reduce burn hypermetabolism probably through the following ways: 1. stimulation of the secretion of insulin and enhancement of the effect of insulin; 2. inhibition of the secretion of glucagon; 3. improvement in tissue insulin resistance and promotion of glucose utilization of skeletal muscles.
Xie
W G
WG
Burn Research Institute, Southwestern Hospital, Third Military Medical College, CPLA, Chongging.
D000818:Animals; D001786:Blood Glucose / Q000378:metabolism; D002056:Burns / Q000188:drug therapy* / Q000378:metabolism; D005934:Glucagon / Q000097:blood; D007328:Insulin / Q000378:metabolism; D000078790:Insulin Secretion; D008297:Male; D011817:Rabbits; D014044:Tolbutamide / Q000627:therapeutic use*
D001786:Blood Glucose; D007328:Insulin; D005934:Glucagon; D014044:Tolbutamide