| Japanese |
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| Title | カテコラミン感受性低下に対するメチルプレドニソロンの有効性の検討 |
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| Subtitle | 原著 |
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| Authors | 関純彦, 土田英昭, 並木昭義, 氏家良人, 表哲夫, 宮部雅幸, 久米田弘幸, 一宮尚弘 |
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| Organization | 札幌医科大学麻酔学教室 |
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| Journal | 循環制御 |
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| Volume | 14 |
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| Number | 2 |
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| Page | 173-180 |
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| Year/Month | 1993/ |
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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」カテコラミン持続投与中の循環不全患者を対象とし, カテコラミン感受性低下に対するコハク酸メチルプレドニソロン(以下MP)500mgの1回静注投与の効果を検討した. MP投与6時間後のカテコラミン投与量減量の成否によって有効群および無効群の2群に分けた. 対象患者15例中10例でカテコラミンの投与量を減量できた. 特に感染性ショック症例の有効率が高く, 8例中7例で有効であった. 有効群ではMP投与1時間後から血圧と左室1回拍出仕事量係数の有意な上昇を示し, MPのカテコラミン感受性改善作用が示唆された. 無効群は有効群に比べてMP投与前より時間尿量, 動脈血中ケトン体比の低値を示し, 代謝性アシドーシスを呈していた. 以上より, MPの有効性にはそれまでの臓器血流の良否が関与している可能性が推察された. |
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| Practice | 基礎医学・関連科学 |
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| Keywords | steroids, methylprednisolone, catecholamines, β-adrenergic receptor, desensitization |
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| English |
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| Title | Effects of methylprednisolone in patients suspected desensitization to catecholamines |
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| Subtitle | |
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| Authors | Sumihiko Seki, Hideaki Tsuchida, Akiyoshi Namiki, Yosihito Ujike, Tetsuo Omote, Masayuki Miyabe, Hiroyuki Kumeta, Takahiro Ichimiya |
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| Authors(kana) | |
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| Organization | Department of Anesthesiology,Sapporo Medical College |
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| Journal | Circulation Control |
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| Volume | 14 |
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| Number | 2 |
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| Page | 173-180 |
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| Year/Month | 1993/ |
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| Article | Original article |
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| Publisher | Japan Society of Circulation Control |
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| Abstract | The effect of methylprednisolone (MP), 500 mg, administered intravenously, was evaluated in 15 patients with circulatory failure who had been dependent on catecholamine infusion for more than 24 hours. Ten patients (group A) showed circulatory improvement (increase in systolic blood pressure, left ventricular stroke work index and urine output) within 6 hours of the injection, allowing a reduction of their dose of catecholamine. Their plasma catecholamine levels were unchanged after the MP injection, indicating that it had improved sensitivity to catecholamine. Five patients (group B) did not show any amelioration in their circulatory status after the MP injection and needed a further increase of catecholamine infusion. Seven out of 8 septic patients responded positively to the MP, whereas none of 3 patients in post-reanimation circulatory shock appeared to benefit. Urine output, arterial ketone body ratio, arterial pH, and arterial base excess were within normal range in group A at the time of MP injection, while they were out of normal limits in group B. The results suggest that MP injection is beneficial for some patients with cirulatory failure whose tissue perfusion has not greatly deteriorated. |
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| Practice | Basic medicine |
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| Keywords | steroids, methylprednisolone, catecholamines, β-adrenergic receptor, desensitization |
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