低血圧性循環調節における循環力学的数値の変動
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概要
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1. In the arterial hypertension the "pression moyenne dynamique (Vaquez)" showed merely the rough tendency to approach to the value diastolic pressure+1/3 pulse pressure, although there existed no close and constant correlation between two sorts of the blood pressure value. Therefore so far as the arterial hypotension is concerned, two sorts of the blood pressure value may be preferable to be acutually measured in each individual. 2. The test dosis of Carnigen (Hoechst) did not so strikingly prove in favour for the , treatment of the hypotensive cases without any subjective claim. However by the chronic use it was possible to elevate the hypotension up to normal extent on an average. The intramuscular injection of 2 cc Carnigen cured within 10', or 60' at the latest, both subjective and objective disturbances observed among those who showed the typical hemo-dynamical changes characteristic of the postural hypotension or were afflicted with dizziness, fainting, palpitation and breathlessness. Carnigen displayed the immediate and reliable effect upon the postural vago-depressor syncope. According to the severity of the condition of the patient, the droplets from five to fifteen pro die were medicated for three or four days. On these occasions asthenia or tiredness frequently seen in the hypotensive patients was also affected in favour. 3. The electrocardiographic changes found in the cases with postural hypotension, above all, the depression of ST.T in the lead II, III and aVF were wellknown since the study of Nordenfelt. Many investigators, especially late Prof. Vdlhard and their collaborators elucidated that most of these electrocardiographic changes can be suppressed by the use of ergot preparates. It wrs clarified in this paper that a certain type of the electrocardiograms refractory against the dihydroergotamine derivate was not rarely found among those who were accompanied with reduced W (peripheral streaming resistance) & E' (volume elasticity) and unchanged M (minute volume), that is, with the "Entspannungsregulation" according to Duesberg-Schroeder, or Reindell. Carnigen proved favourably in those cases; even by the oral use the depressed ST.T was gradually normalized. The side effect of the therapeutic dosis could hardly be seen. Though palpitation and or anorexia rarely appeared, they were almost transitory and were used to be well tolerated by patients during the protracted medication. 4. The cardio-vascular dynamical anlysis was performed in 46 patients with essential hypertension at the untreated blood pressure level, then at the optimal blood pressure level and lastly at the floor of the blood pressure in the sense of Smirk and Doyle. The "optimal" is meant by us the blood pressure level at which stroke and minute volumes as well as peripheral streaming and elastic resistances of the patient are approximated to the normal range as possible as they are, by the use of the depressant drugs, mainly hydrazinophthalazine, ganglionic blocking agents of secondary or tertiary amine and chlorothiazide or its derivates. In addition to these patients, 17 cases with normotension were also analyzed as the control with the same methonds. Orthostatic changes were all investigated at 5' after the standing. The orthostatic hypotension in which systolic pressure was reduced 20 % or further showed the "Anspannungsregulation" and the "Druckreaktion" in the sense of Blumberger regardless the three states of the blood pressure above mentioned. In the group of which reduction rate of systolic pressure ranged within 10 %, 33 measurements showed the slight elevation of diastolic pressure while 10 measurements the slight lowering, i.e. the "Hypodyname Reaktion" in the sense of Schellong, among the latter the "Entspanungsregulation" (Duesberg-Schroeder or Reindell) was seen only in three measurements. Consequently there must be paid attention not to intermingle the "Hypodyname und Hypotone Reaktion" (Schellong) and the "Entspanungs-und Anspanungsregulation" (Duesberg-Schroeder or Reindell).
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