開心術前後におけるシニン・アンギオテンシン・アルドステロン系の変動
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概要
- 論文の詳細を見る
Plasma renin activity (PRA), plasma concentration of angiotensin II (AII) and aldosterone(Ald) were measured in 64 adult patients undergoing open-heart surgery. The patients were divided into two groups according to their postoperative course : the catecholamine group consists of the patients requiring catecholamine postoperatively, and the control group consists of the remainders, namely the group requiring no catecholamine postoperatively. Significant correlation was observed between PRA and/or Ald and the severity of preoperative cardiac dysfunction. When anesthesia and operation started, PRA, AII and AId increased. They decreased transiently at the start of cardiopulmonary bypass (CPB), but gradually increased thereafter. In the catecholamine group, PRA, AII and AId remained at high levels for several days postoperatively, while they returned to normal within 24 hours in the control group. Significant correlation was observed between postoperative Ald and maximum BUN. Remarkable elevation of PRA, up to 96 ng/ml/h, and AII, up to 5,000pg/ml, were seen in eight patients, and showed severe postoperative courses, most of whom underwent emergency cardiac surgery. Two of these eight patients required IABP and assisting cardiopulmonary bypass, two required IABP and dialysis, and one required IABP alone postoperatively. Four out of these eight patients died, suggesting untoward effect of abnormally elevated R-A-A system especially of AII on tissue of vital organs.
- 神戸大学の論文