心脈管分析と電解質,とくに,Hegglin症候群との関係
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概要
- 論文の詳細を見る
1. While hyperkaliemia and hypernatremia were found respectively in 29 % among 53 cardiac patients, the former was observed in 37%, the latter in 29 % among the decompensated group. However there exist some exceptions in this tendency, for instance, the patients complicated with marked symptoms of chronic congestive liver showed often, on the contrary, the hypokaliemia. 2. So far as the patients upon whom digitalis had responsive effect were concerned, roughly in proportion to the convalescence of congestive symptoms, Na and K in serum became within normal limits, and those in urine increased in their amounts, especially Na was markedly excreted in company with diuresis. Cardiac output, extracellular fluid and total blood quantity tended also to be normalized, although these changes were not necessarily parallel with the improvement of symptoms; sometimes the recovery of ecg. graphic patterns or certain clinical symptoms preceded that of dyselectrolytemia. 3. The carbonic anhydrase inhibitor resulted often in excess K loss in the urine, possibly by the direct action of the drug upon the tubular epithelium. It may be worthy of note that the carbonic anhydrase inhibitor produces loss of K even when no diuresis takes place. 4. The increase of Na and K in urine were observed during the Mictin-diuresis which occurred as a rule within one or two days ofter the medication, although the former was more striking in its degree than the latter. The side effects could be managed only by the cessation of the medication without any special measure. 5. The dosage of Hydrazinophthalazine which reduces systolic pressure by 10〜30 mmHg, diastolic by 10 mmHg tended to increase the amount of anorganic P and sugar in serum, although within normal range. 6. Blumberger-Holldack's analysis was performed upon 20 cases with hyperkaliemia. As to ASZ the diminution was found in 20%, the prolongation in 35%. Regarding ATZ, there could not be any case with the prolongation; the diminution was observed in 50%. The premature finishing of QIL tone interval was seen in 40%, but in this observation Prof. Wuhrmann's management was not perfomed. This percentage, despite of native estimation, is far less than that of Prof. Pendl who insisted the occurrence of diminished QII ton interval in 70% of his cases with hyperkaliemia; the disagreement may at least be referred to the severity of the hyperkaliemia or of the underling disease. 7. Among the patients with hypokaliemia, the diminution of ASZ and ATZ was found in 50% and QIE tone interval was prematurely finished or prolonged in each same percentage. Some cases complicated with hypokaliemia showed definitely the reduction of the cardiac work (output × arterial mean pressure). Therefore, setting apart temporally the discussion about "Dynamische Herzinsuffizienz" and "Energetisch-dynamische Herzinsuffizienz", so far as the meaning above mentioned is concerned, it may be safe to say that among a certain part of Hegglin's syndrome there exists one special mode of cardiac insufficiencies.
- 千葉大学の論文
- 1959-09-28