本態性高血圧症の副腎皮質機能に就いて
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概要
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As to the patients suffering from the essential hypertension whose systolic pressure more than 150mmHg, I measured the urinary total 17OHCS, 17KS and 17KS fraction, and administered ACTH Gel (14Units × 2) to all of the cases, and with its variation examined the adreno-cortical reserve concretely and synthetically. And also investigated the connection of the adreno-cortical reserve with eosinophil response and other clinical observations.<BR>There was no difference in particular between the hypertension patients and normal persons on the excretion quantities per day of urinary total 17OHCS, 17KS and the rate of increase on a day when ACTH administered. But observing the variation process of each of them during three days including ones just before and after the administration day, I recognized more so-called 'the type of abnormal responsiveness' showing the delay of increase or non-response among the hypertension patients. On the measurment of urinary 17KS fraction there was a tendency to increase IV V fraction among male patients of hypertension, and when administered ACTH the variations divided into three types ; one showing III VI VII fraction increase, showing IV V fraction increase, and fraction unvarying. As these variations have some constant connection with varied quantities of total 17OHCS and 17KS on the day of ACTH administration, the adreno-cortical function can be divided into three main types ; sufficiency, comparative-insufficiency, and insufficiency. The types of insufficiency and comparative-insufficiency have their causes in lowering of adreno-cortical responsiveness or impediment in cortical metabolism, and there have been occupied 70% of all the essential hypertension cases, which showed the lowering of cortical function. Among the 70% there are many cases in which hypertension has been continued during long term and also arteriosclerosis has particularly been in advanced stage. Their eosinophil responses, too, were much worse than others.
- 一般社団法人 日本内分泌学会の論文