心疾患,とくに,心冠疾患にたいするAdenosineおよびTheophylline誘導体(Parmanil)の臨床的評価
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概要
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Both adenosine and oxyaethyl-theophylline derivates are used very often for the treatment of coronary insufficiency. Parmanil (Hoechst) is an excellent medical mixture of these two derivates so far in use. In this clinic, Parmanil is also indicated for the treatment of some diseases other than coronary insufficiency. Making an exception of such cases as defective to collectively evaluate the therapeutic actions of Parmanil, 25 cases were selected in order to investigate whether Parmanil can be applied as the supplementary cardiotonicum. First of all the effect of Parmanil used acutely upon cardio-respiratory function was analyzed. The results of this observation eluciated that Parmanil improves the disturbed gas-phase and is cardiodynamically efficacious. In the next place, the mode of action of Parmnil was investigated in each csae in order to clarify the clinical value, and the following results were obtained. 1. Parmanil improves the coronary circulation. The development of collateral circulation is advanced, and the decrease either in the voltage of injury current or in the area of ischaemia can be expected. Consequently both subjective and objective improvements are possible within relatively short time in the cases suffered from coronary sclerosis, angina pectoris and myocardial infarction. As to the evaluation in the latter group, the therapeutic effectiveness is closely observed with special reference to superficial, non-penetrating and subendocardial infarction. There exists a small number of patients who are refractory against the singular use of Parmanil until the anticoagulants are combined. 2. Two patients suffered from so-called coronary failure were treated with Parmanil. In Case 3 the fresh sign of coronary occlusion happened to appear during this observation. The favourable influence of Parmanil upon coronary circulation is also efficacious for the remedy of the cardiac pain. 3. In the valvular disorders and hypertensive cardiac diseases complicated or threatened with congestive heart failure Parmanil shows the excellent effectiveness as the supplementary cardiotonicum. Parmanil is also valid for the prevention of the cardiac pain occasionally observed during the antiluetic therapy, even very cautiously performed, of the syphilitic aortic regurgitation. 4. Parmanil shows the good efficacy upon the cardiogenic bronchospasm which must be differentiated from cardiac asthma of cardiac dyspnea due to pulmonary congestion. 5. For the.relief of the anginal pain observed in emphysematous heart, Parmanil is effective and improves the disturbed respiratory function especially the disordered gas-phase. 6. With the combined use of digitalis, or strophantin, Parmanil smoothes the mode of action of cardiac glucosides and reduces the appearance of their side effects. Consequently the combined application of cardiac glucosides and Parmanil proves effective not only in valvular diseases with severe congestive heart failure, but also in fresh myocardial infarction with acute diminution of cardiac reserve. Parmanil serves as a good supplement at the rapid digitalization by means of Cedilanid or other cardiac glucosides with immediate response. In all cases cardiodynamical values determined by Blumberger-Holldack's method and vascular dynamical values estimated by Wezler's method were discussed with due regard to the data obtained by cardiac catheterization, vector analysis of ecg and x-ray kymography etc.
- 千葉大学の論文