糖尿病,および,その他の疾患におけるHegglin症候群,とくに,エネルギー性力学的心不全(Hegglin)と心筋症(Wuhrmann)の重なり合いについて
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232 cases with or without dysproteinaemia or dysproteinaemia were divided into ten groups accordingly the sorts of underlying diseases (Tbl. 1), and QT and QIC ton were examined in order to investigate the frequency of the occurrence of Hegglin's syndrome. 1. In the assumption of the criterion upon the diminution of QII as 350_σ, the positive occurrence ratio of Hegglin's syndrome is 23.6 %, whereas in the assumption of QT-QII> +40_σ the positive Hegglin is counted at 8.5 %. Moreover, taking it for granted to add the absolute prolongation of QT to two sorts of the criterions above mentioned, the positive Hegglin is reduced at 5.1 % in the former group, and 6.4 % in the latter group respectively. It is noteworthy to say that those who lack the clinical findings emphasized by Hegglin or the sign of cardiac insufficiency are included among two sorts of these group. Therefore it may be safe to say that Hegglin's syndrome complicated with "Energetisch-dynamische Herzinsuflfizienz" should be meant by those conditions in which QII is measured less than 338_σ, besides the absolute prolongation of QT. Under such a definition, Hegglin's s/ndrome complicated with "Energetisch-dynamische Herzinsuffizienz" is found only in 8 among 232 Cases (3.4%). 2. So far as this observation is concerned, it can not be concluded that Hegglin's syndrome is observed frequently in any specific disease. 3. 7 of 8 patients with "Energetisch-dynamische Herzinsuffizienz" were dead and except for one case, examined at autopsy which elucidates the mucoid degeneration of cardiac muscles in all cases. Our collaborators have repeatedly reported the wide overlapping between myocardosis (Wuhrmann) and E. D. H. I. (Hegglin) with respect to clinical and laboratory findings although both disorders can be not seldom observed independently.4. 50 % of essential hypertension or hypertensive disease without dysproteinaemia or dyselectrolytaemia showed the prolonged QII i.e. 39% of the cases the normal range, whereas 24 % of essential hypertension or hypertensive disease with dysproteinaemia or dyselectrolytaemia showed the prolonged QII, 68 of them the normal range, so that the distribution frequency of QII duration in the latter group became similar to that in normal health. The number of cases with prolonged QT can be arranged the hypertensive group with dysproteinaemia or dyselectrolytaemia, the hypertensive group without dysproteinaemia or dyselectrolytaemia, and the normal health in order of the extent of the prolongation. 5. There exists the possibility to be converted from "Dynamische Herzinsuffizienz" into "E. D. H. I." (Hegglin) by the complication of dyselectrolytaemia or combined dysproteinaemia in the sense of Wuhrmann. 6. The other group of 18 diabetic patients without dyselectrolytaemia, dysproteinaemia or hepatic dysfunction was examined by means of Wezler's and Blumberger-Holldack's methods. Two cases with QT-QII>20_σ and 3 with QTc-QII_c>40_σ were found in groups of mild or moderate severity. One patient suffered from precoma showed "Energetisch-dynamische Herzinsuffizienz" which disappeard after the insulin treatment. Most of them showed peripheral dynamically "Anspannungsregulation" in the sense of Duesberg and Schroeder, and cardiodynamically "Druckreaktion" in the sense of Blumberger. The possibility of the occurrence of Hegglin's syndrome without marked dyselectrolytaemia or dysproteinaemia was discussed with special reference to the myocardial metabolism in diabetes mellitus.