硬膜外類固醇注射對豬隻血糖值的劑量反應

Dose-responsive Effect of Epidural Triamicolone on Blood Glucose Concentration Profiles in Piglets

背景及目的：硬脊膜外注射類固醇會引起高血糖的反應，本研究目的是探討不同劑量triamcolone的硬脊膜外注射，在豬動物實驗中血糖濃度變化。研究設計：共實驗24隻豬，體重在18到22公斤，且隨機分成4組。於氣管插管全身麻醉後，每隻豬隨機進行不同劑量triamco1one的硬脊膜外注射。依注射triamico1one的劑量是1毫克／公斤、2毫克／公斤和3毫克／公斤，分別為第I、II、III組。我們也設計對照組豬接受硬脊膜外生理食鹽水注射。在注射後4小時內，每小時抽取周邊動脈血測量血糖值。計算和基本血糖值變化的百分比並以變異性分析法分析。實驗結果：在實驗期間，只有第III組有顯著的血糖上升。在整個實驗期間，第III組的血糖變化值明顯的高於對照組。分別在120分鐘和180分鐘，第I組和第II組的血糖變化值明顯的高於對照組。和對照組相比，第I組、第II組和第III組在180分鐘時有顯著的血糖最大增加幅度（第I組、第II組和第III組分別為6.2±3.5%，7.1±4.3%和11.4±6.5%；對照組為一29.7±11.5%）。研究結論：除了在實驗期間有較高注射劑量以外，健康豬隻triamcolone硬脊膜外注射可能不會引起明顯的血糖上升反應。實驗應進一步探討在糖尿病個體的血糖變化。

Background: Epidural steroid injection may have hyperglycemic effect but is rarely investigated. The aim of this study was to explore different doses of epidural triamicolone on blood glucose concentration change in piglet model. Materials and methods: We enrolled 24 piglets, weight 18 to 20 kg and randomly allocated into four groups. After general anesthesia induction and orotracheal intubation, each piglet underwent epidural injection of randomized regimen. The epidural triamicolone was injected for studied piglet, and the dose for piglet in group I, II and III were 1, 2 and 3 mg/kg respectively. We also designed control group, of which piglets received epidural saline injection. Blood glucose was measured from peripheral arterial blood sample after induction and then every one hour for 4 hours. Blood glucose variations in % of baseline value were calculated and analyzed with analysis of variance (ANOVA). Results: Only group III showed significantly increased blood glucose concentration within study period. Group III had significantly higher glucose concentration (% of baseline) than control group during all study period. Group I and II had significantly higher glucose concentration (% of baseline) than control group at 120 and 180 min. Comparing with control group, the maximal magnitude of increase (%) was significantly in group I, III and III at 180 min (6.2±3.5%, 7.14.3% and 11.4+6.5% for Group I, III and III; -29.7 11.5% for control group). Conclusion: Epidural triamicolone injection might not increase blood glucose level significantly in healthy piglets except in higher dose within study period. The data should be applicable carefully for diabetes subjects.