Japanese
Title血漿抱合型noradrenalineの脱抱合の場所と動態に関する研究―特に左心ポンプ機能障害と動的運動負荷の関与について―
Subtitle原著
Authors各務雅夫, 伊藤裕康, 湊口信也, 浅野喜代治, 今井洋子, 越路正敏, 宇野嘉弘, 横山仁美, 平川千里
Authors(kana)
Organization岐阜大学医学部第2内科
Journal循環制御
Volume13
Number3
Page441-448
Year/Month1992/
Article原著
Publisher日本循環制御医学会
Abstract「要旨」(1)軽症心疾患患者(n＝23)の同時採血における肘静脈血と肺動脈血の比較にて, 安静時遊離型noradrenaline(NA)とadrenaline(A)濃度は, 肺動脈血＞肘静脈血, 安静時抱合型NAとA濃度は, 肺動脈血＜肘静脈血であった. このことは脱抱合の場所が心臓(心筋)であることを示唆する. (2)健常者(C群, n＝15), 左心ポンプ機能良好例(N群, n＝50), 障害例(H群, n＝68)の安静時遊離型NA濃度は, H群＞N群≒C群, 抱合型NA濃度は, H群＞N群＞C群であった. 一方, 安静時遊離型A濃度は, 3群間で差を認めなかった. 抱合型A濃度は, H群＞N群≒C群であった. また, 動的運動負荷時, 遊離型NAとA濃度は増加, 抱合型NAとA濃度は減少, かつ, 遊離型と抱合型NA濃度の変化量は, N群＜H群であった. この事実は, 抱合型NAが運動負荷時に脱抱合され, 遊離型NAとなり, 生体によって使われている可能性を示し, かつ, 抱合型NAは左心ポンプ機能の障害とともに血漿レベルが上昇し, おそらく, 左心ポンプ機能障害を代償する機序の1つとして役立っていると考えられた. 遊離型NAは各瞬間の交感神経緊張度を反映し, 抱合型NAは時間について積分された交感神経緊張度を反映すると推定された. また, 抱合型NAの一部は心臓にて脱抱合されている可能性が示唆された.
Practice基礎医学・関連科学
Keywordsplasma conjugated noradrenaline and adrenaline, left-sided pump dysfunction, dynamic exercise, site of deconjugation
English
TitleSite and Dynamics of the Plasma Noradrenaline Deconjugation -with Special Reference to the Left-Sided Pump Dysfunction and Dynamic Exercise-
Subtitle
AuthorsMasao Kakami, Hiroyasu Ito, Shinya Minatoguchi, Kiyoji Asano, Yoko Imai, Masatoshi Koshiji, Yoshihiro Uno, Hitomi Yokoyama, Senri Hirakawa
Authors(kana)
OrganizationThe 2nd Department of Internal Medicine,Gifu University School of Medicine
JournalCirculation Control
Volume13
Number3
Page441-448
Year/Month1992/
ArticleOriginal article
PublisherJapan Society of Circulation Control
AbstractTo investigate the variations of conjugated noradrenaline (NA) and adrenaline (A) with dynamic exercise and pumping function of the left heart, we compared plasma levels of free and conjugated NA and A before and during exercise in control subjects (group C, n=15), cardiac patients with a normally functioning (group N, n=50) and a poorly functioning left heart (group H, n=68). To study the possible site of deconjugation, we compared plasma levels of free and conjugated NA and A between antecubital vein blood and pulmonary artery blood. 1) Plasma levels of free NA and A were higher in the pulmonary artery blood than in the antecubital vein blood. Plasma levels of conjugated NA and A were lower in the pulmonary artery blood than in the antecubital vein blood. 2) The relationship in the plasma levels of free NA was group H>group N≒group C. The relationship in the plasma levels of conjugated NA was group H>group N>group C. There was no difference in the plasma levels of free A between the 3 groups. Although there was no difference in the plasma levels of conjugated A between groups N and C, it was significantly higher in group H than in group C or N. Plasma levels of free NA and A increased during dynamic exercise, and the increment of plasma NA was greater in group H than in group N. Plasma levels of conjugated NA and A decreased during exercise, and the decrement of conjugated NA was greater in group H than in group N. These findings suggest that, while plasma free NA reflects the instantaneous sympathetic nerve activity, plasma conjugated NA may reflect the time-integrated sympathetic nerve activity. It is probable that the plasma conjugated NA can be deconjugated and converted into plasma free NA in the heart.
PracticeBasic medicine
Keywordsplasma conjugated noradrenaline and adrenaline, left-sided pump dysfunction, dynamic exercise, site of deconjugation

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