| Japanese |
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| Title | 術中の血圧調節薬として用いたNicardipineと心房性ナトリウムポリペプチドの腎への作用機構 |
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| Subtitle | 原著 |
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| Authors | 後藤文夫*, 渡辺巖*, 寺田政光*, 須藤至**, 藤田達士* |
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| Organization | *群馬大学医学部麻酔・蘇生学教室, **済生会宇都宮病院麻酔科 |
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| Journal | 循環制御 |
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| Volume | 11 |
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| Number | 4 |
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| Page | 503-508 |
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| Year/Month | 1990/ |
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| Article | 原著 |
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| Publisher | 日本循環制御医学会 |
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| Abstract | 「要旨」手術中に収縮期血圧が150mmHg以上に上昇した成人開腹手術患者12名を対象として, 降圧薬として用いたNicardipineとヒト心房性ナトリウムポリペプチド(hANP)の腎機能への作用機構を比較検討した. Nicardipine 1μg/kg/分の持続静注で収縮期血圧は166.5±16.2mmHgから15分後には146.3±21.1mmHgに低下したのに対して, hANP 0.2μg/kg/minの投与では171±12.4mmHgから153.6±17.9mmHgと軽度な低下で目標の血圧に達しなかった. 注入開始30分後には両群ともにそれぞれ132.2±12.6mmHg, 136.4±8.8mmHgと目標値に低下した. 尿量はNicardipine群が投与前値の約4倍, hANP群が約10倍に増加した. 今回の成績で注目すべき点は, 1)GFRはhANP群のみ有意に増加した, 2)近位尿細管再吸収能の指標としたPO4排泄は両群ともに有意に増加した, 3)遠位尿細管Na再吸収抑制率(DTRFNa)はhANP群のみ上昇した. 以上の成績より, NicardipineはGFRに影響を与えることなく, 近位尿細管の再吸収を抑制して尿量を増加させることが示唆された. 一方, hANPはGFRの増加と近位並びに遠位尿細管の再吸収抑制を介してNa利尿を発現することが示唆されたが, いずれが主要な作用部位かは決定できなかった. |
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| Practice | 基礎医学・関連科学 |
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| English |
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| Title | The effects of nicardipine and human atrial naturiuretic polipeptide on renal function and systemic blood pressure |
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| Subtitle | |
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| Authors | Fumio Goto, Iwao Watanabe, Masamitsu Terada, Itaru Sudo, Tatsushi Fujita |
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| Authors(kana) | |
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| Organization | Gunma University School of Medicine Department of Anesthesiology and Resuscitology |
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| Journal | Circulation Control |
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| Volume | 11 |
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| Number | 4 |
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| Page | 503-508 |
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| Year/Month | 1990/ |
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| Article | Original article |
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| Publisher | Japan Society of Circulation Control |
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| Abstract | The effects of calcium entry blocker, nicardipine hydrochloride, a dihydropyridine derivative, on blood pressure and renal imction were compared to those of human atrial naturiuretic polypeptide (hANP) in hypertensive surgical patients. Systolic blood pressure decreased from 166±16 mmHg to 132±12 mmHg and from 171.1±12.4 mmHg to 136.4±8.8 mmHg, respectively, in nicardipine group and hANP group 30 min after the start of drug infusion. Urine flow, sodium and inorganic phosphate excretion significantly increased following the administration of the drugs in both Groups. GFR and Distal tubular rejection fraction of sodium (DTRFNa) (1-Fractional distal sodium reabsorption) increased significantly due to hANP infusion, but those of nicardipine Group did not change. Plasma sodium and inorganic phosphate did not change in both Groups. Phosphate reabsorption is considered to be largely in the proximal renal tubule, so its appearance in the urine in increased quantities suggest proximal activity of nicardipine, as neither the GFR nor plasma phosphate concentration was affected. On the contrary, diuresis due to hANP will be depend on the increase of GFR and the inhibition of proximal and distal sodium reabsorption. |
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| Practice | Basic medicine |
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