クリアランス法に依る疫痢・赤痢の腎機能の研究

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The author performed investigations on the renal function in 6 cases of ekiri: and the same number of cases of dysentery by means of the clearance test, using Cthio and Cpah. The results are summarized as follows: (1) All the 6 cases of ekiri and the 4 cases of dysentery showed values lower than the normal level in GFR, and the rate of 'lowering was more marked in ekiri than in dysentery. In RBF, all the 6 cases of ekiri and the_5 cases of dysentery showed values lower than the normal level and the reduction was far more marked in ekiri than in dysentery. In FF, however, the 5 cases of ekiri showed values markedly higher than the normal level, while the 4 cases of dysentery also showed values higher than the normal level. In RR, all the 6 cases of ekiri showed lower values at the beginning of hospitalization , than at the time .of discharge from the hospital. However,. the 4 cases of dysentery showed higher values and the other 2 cases of ekiri showed lower values in RR at the beginning of hospitalization than at the time of discharge from the hospital. In inverse. proportion to the values of RBF, those of PRU showed markedly larger increase in ekiri than in. dysentery in all the cases under investigations. (2) An examination of the relationship of the values of GFR, RBF, FF and PRU to one another disclosed that all the cases of ekiri showed a decrease in GFR and RBF and 1 cases in FF, while 5 cases and 6 cases showed an increase in FF and PRU, respectively. This will evidence that ekiri inflicts greater damage than dysentery. (3) An examination of the transition in the renal function revealed that the normalization of the values of GFR and RBF was delayed in ekiri than in dysentery and that the normalization of the values of RBF, which had shown larger reduction than those of GFR at the height of the disease, was delayed than that of the values of GFR-in fact they still stood below the normal level at the time of discharge from the hospital. (4) In spite of the fact that a marked oliguria existed in ekiri, all the cases of ekiri showed values lower than the normal level in RR and the normalization of the value took longer than in dysentery. It seems that this could be attributed to a marked and persistent decrease in the values of RBF and to the pathological change occurring simultaneously in the cells of the renal tubules. (5) The picture of renal function presented by the cases of ekiri and dysentery agreed well with that presented at the time of secondary shock. It is inferred that, in ekiri, the change which corresponds to that occurring in the ishemic phase according to the theory held by Van dyke, is beginning to take place in the renal damage phase. (6) The results of renal function tests performed in ekiri have revealed that the contraction of blood vessels of high degree will occur in the kidneys as a result of the dominance of the sympathetic nervous system over the general functioning of the body organs, and that marked similarity exists between the pathological pictures of the kidneys in ekiri and secondary shock. (7) It is concluded from the above observations that a marked lowering in the values of GFR and RBF evidences the existence of the excretory disturbance of high degree; that a lowering in the values of RR proves the reduction in the water maintaining capacity; and that these changes contribute to the development of acidosis and dehydration in ekiri.
千葉大学の論文

クリアランス法に依る疫痢・赤痢の腎機能の研究

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