開心術前後における高レニン、高アルドステロン血症に対する抗アルドステロン剤及びアンギオテンシン転換酵素阻害剤の効果に関する臨床的研究
スポンサーリンク
概要
- 論文の詳細を見る
Previous study in this institution indicated that the occurrence of low output syndrome and renal impairment after open-heart surgery was greatry affected by activated renin-angiotensin-aldosterone (RAA) system. In order to prevent this effect, canrenoate potassium was administered in 10 open-heart cases post-operatively (Group 1) and captopril in 6 cases pre-and postoperatively (Group 2). Evaluation was made in these 2 groups in comparison with control group which consisted of 19 open-heart cases without administratin of these drugs. Following results were obtained;1) administraition of canrenoate potassium brought about increase of urine volume, improvement of free water clearance and suppression of urine potassium excretion as decrease in K/Na ratio in Group 1 without showing any remarkable change in hemodynamics. There was no significant change in plasma renin activity, plasma angiotensin II level and plasma aldosterone level.2) Adoministration of captopril resulted in the elevation of renin activity associated with reduction of angiotensin II level and plasma aldosterone level in Group 2. Increase of urine volume and improvement of creatinine clearance as well as suppression of urine potassium excretion and decrease in urine K/Na ratio were observed in this group. Although reduction of total systemic resistence was seen after administration of captopril, significant increase in cardiac output was not observed. Conclusion; Canrenoate potassium and captopril improved water and electrolyte metabolism in patients following open-heart surgery. Moreover captopril reduces vascular resistence, favaring circulatory condition, administration of canrenoate potassium and captopril appears to be a rational approach for the prevention and treatment of LOS and renal dysfunction following open-heart surgery.
- 神戸大学の論文