血球のNa, K代謝の研究 : I. 心腎疾患における血球内Na, K濃度
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During the course of the investigation on the electrolyte metabolism in cardiovascular and renal patients, our attention was called to the great variance of sodium content of blood cells, in contrast to the constancy of the electrolyte in blood plasma except in extremely severe states. While many works have been made on the electrolyte changes in the extracellular fluid in diseased states, little is known about the changes in the intracellular phase.In this paper the results of the estimation of the contents of sodium and potassium in blood cells and plasma in 81 cardiovascular and renal patients and 22 normal subjects are reported and their clinical meanings are studied. The concentrations in cells were calculated from the values of whole blood, blood plasma and hematocrit.The results are as follows : 1. In normal subjects, sodium and potassium concentrations in blood cells were 11.4±7.05 mEq/L (13.5±7.12 mEq/kg H_2O), and 87.5±6.08 m Eq/L (127.5±12.33 mEq/kg H_2O) ratio of the total sodium and potassium concentration in blood cells to that in blood plasma was 0.69±0.07 in mass volume or 0.90±0.099 in water.2. In non-edematous cases, including essential hypertension, all the above values and ratio were within normal ranges. In edematous patients the sodium concentration and the ratio described above were in general significantly higher, except the ratio in 2 nephrotic cases : In edematous chronic glomerulonephritis and nephrosclerosis, sodium concentration 42.8±16.87 mEq/L, potassium concentration 83.7±10.54 mEq/L, the total concentration 126.4±20.56mEq/L, the ratio 0.93±0.15. In edematous cardiacs, 19.1±18.1 m Eq/L, 95.5±10.87mEq/L, 115.1±18.10 mEq/L, 0.83±0.153,and in nephrosis, 22.6mEq/L, 79.4 m Eq/L , 101.5 mEq/L, 0.71,respectively.3. The cell sodium concentration was negatively correlated to the cell potassium concentration but the total concentration of sodium and potassium can be markedly elevated due to the sodium increase in cells. In edematous subjects, sodium and potassium contents of blood cells and the total contents of the two were negatively correlated to the corresponding values respectively. No such correlation was seen in non-edematous subjects.4. Systolic blood pressure, glomerular filtration rate and total plasma protein were correlated to the sodium concentration of blood cells in some degree, but not to the potassium contentration. The latter was in reversed correlation to the hematocrit value.5. Sodium concentration in blood cells is increased in severe stage of cardiovascular and renal diseases. This increase may be the result of the reduced metabolic function of blood cells.
- 社団法人日本循環器学会の論文
- 1959-01-20