若年者に見られる高血圧症の循環分析 : 附:甲状腺機能異常症における循環分析

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The age of so-called juvenile hypertension is limited under 30 years old according to Master's statistics (1952). The haemodynamics was analyzed in 40 cases with juvenile hypertension comparing Wezler's new method with Fick-Cournand's method. The blood pressure level of juvenile hyperension is as a rule labile and tends to approach the normal range by means of the psycho-somatic quiet. The systolic pressure of 40 cases was on the average estimated at 149 mmHg through the observation, while the diastolic at 74. According to Wezler-Boger's classification among 40 cases "Minutenvolumenhochdruck" (M) was found in 26, "Widerstandshochdruck" (W) in 12, "Elastizitatshochdruck" only in 2. Of 26 cases with M form, the basal metabolism was augmented in 13 which had tendency to show both relatively low diastolic pressure and large pulse pressure. The electrolytes in sera were determined in the normal range. Regitine-test was negative in all observations. According to Keith-Wagener's classification the III type was seen in two cases with M and in one case with W, the II type only in one case with W, and all other cases showed the I type. In one case with M among two malignant hypertensives in the sense of Schroeder the renal insufficiency was already. assured at the first examination. This sort of high output may be considered as the final compensatory mechanism in the terminal stadium of the renal insufficiency. Another malignant hypertensive patient without serious syndrome of renal failure showed W+e' and by means of the treatment the subjective claim was improved, the augmentation of the peripheral resistance was reduced. The prehypertensive state can not necessarily be concluded to promise to develop to the manifest arterial hypertension in future. However the direct shift to the malignant hypertension from the prehyprtensive state could exactly be followed in one case. In order to diagnose juvenile hypertension the secondary high blood pressure due to Cushing's syndrome, toxaemia in pregnancy, phaeochromatocytoma, etc., must be excluded and by means of the measurement of the blood pressure in lower extremities in addition to x-ray examination the coarctation of aorta also must be differentially diagnosed. Psycho-somatic rest is necessary for the management of juvenile hypertension distinguished by M form and especially for that of case complicated with increased basal metabolism Methylthiouracii and allied drugs are proved effective.
千葉大学の論文

若年者に見られる高血圧症の循環分析 : 附:甲状腺機能異常症における循環分析

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