高血壓症と腎機能(第6報) : 臨床的研究 : 神經性高血壓症
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III) NEUROGENIC HYPERTENSION The neurogenic factor plays an important but not decisive role in the development of hypertension. I have never observed the pure neurogenic hypertension and therefore, I attempted to examine how much role neurogenic foctor plays in various kinds of hypertensions, especially in essential hypertension. For the purpose, I used hexamethonium, 1-hydrazinophthalazine, Rauwolfia Serpentina and phenobarbital.a) 1-Hydrazinophthalazine (Apresoline) : The effects of Apresoline on the renal hemodynamics and blood pressure were observed in 14 hypertensive patients and 1 normotensive ; doses of 0.4 mg/kg, subcutaneously injected. After injection, a reduction of arterial pressure occurred in all cases and this began to develop within 10 minutes and was restored in about 1-2 hours. Then, a slight increase of pulse rate, marked increase of renal blood flow and reduction of filtration fraction were found in 14 cases.Apresoline was orally administered continuously to 7 hospitalized patients (6 with essential hypertension and 1 with chronic glomerulonephritis) and gave favorable results in 6 patients except one patients with nephritis.b) Hexamethonium Bitartarate : By intravenous injection, renal blood flow decreased paralleling with lowering of arterial pressure initially and then returned to approximately control value despite more lowering of blood pressure.c) Rauwolfia Serpentina (Serpasil) : Cardiac and renal functions of 10 hypertensive patients (8 essential and 2 renal hypertensive) were observed before and after single intravenous injection of Serpasil (1-3mg). Reduction of systolic pressure (20-30mmHg) occurred in 7 patients and its maximum existed within 1-3 hours after injection in 6 cases and other 3 cases showed rapid reduction within 15 minutes without latent time. Renal blood flow increased moderately 5 in cases, no changes in 3 cases and decreased slightly in 2 cases. Filtration fraction did not show consistent changes.In oral administration, renal functions showed the similar tendency.d) Phenobarbital : If phenobarbital is administered in nervous patients with hypertension, renal vasospasm would decrease and renal blood flow would increase. I observed in 7 patients (5 with essential hypertension and 2 renal hypertension) changes of renal hemodynamics before and after single subcutaneous injection of 0.1 gm and oral administration of 0.1 gm. In 5 patients with essential hypertension, renal blood flow increased but filtration fraction was unchanged.Next, effects of lumbal puncture on renal hemodynamics were observed. With reduction of cerebrospinal fluid pressure decreased, renal blood flow and glomerular filtration rate decreased and filtration fraction was unchanged.
- 社団法人日本循環器学会の論文
- 1958-09-20
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