| Japanese |
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| Title | 心臓血管手術後のαhANP離脱困難症例の検討 |
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| Subtitle | 症例 |
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| Authors | 春名優樹*1, 公文啓二*2, 矢作直樹*2, 渡辺泰彦*2, 林英明*2, 松井淳棋*2 |
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| Authors(kana) | |
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| Organization | *1大阪大学医学部麻酔学教室, *2国立循環器病センター外科系集中治療科 |
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| Journal | 循環制御 |
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| Volume | 18 |
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| Number | 3 |
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| Page | 409-413 |
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| Year/Month | 1997/ |
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| Article | 報告 |
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| Publisher | 日本循環制御医学会 |
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| Abstract | 「要旨」α型ヒト心房性ナトリウム利尿ポリペプチド(hANP)はこれまでと異なる作用機序の降圧利尿薬で, 通常の利尿薬に応答しない場合にも有効である. 今回われわれは少量投与からの中止で著明に尿量減少をきたした長期投与2症例を経験し, この症例につきhANP投与中止前後で腎機能, ナトリウム利尿ペプチド系を比較検討した. hANP投与中止に伴い血中ANP, BNP濃度が連動して低下し, 血中cGMP濃度は著減した. この結果尿細管に対する効果が減弱し乏尿となったと考えられた. 長期投与例でのhANPの離脱は慎重に行う必要がある. 「はじめに」α型ヒト心房性ナトリウム利尿ポリペプチド(hANP)は受容体型グアニリル・シクラーゼAに作用して血管拡張作用, 利尿作用を発揮する新しいタイプの降圧利尿薬である1). われわれは肺鬱血・心不全があり通常の利尿法に十分応答しない心臓血管手術後患者にhANPが有効であることを報告してきた2). |
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| Practice | 基礎医学・関連科学 |
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| Keywords | hANP, BNP, cGMP, Oliguria |
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| English |
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| Title | Cases Which Were Hard to Discontinue hANP Infusion at Very Low Doses after Long-term Use in Cardiovascular Patients |
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| Subtitle | |
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| Authors | Masaki Haruna*1, Keiji Kumon*2, Naoki Yahagi*2, Yasuhiko Watanabe*2, Hideaki Hayashi*2, Junki Matsui*1 |
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| Authors(kana) | |
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| Organization | *1Department of Anesthesiology, Osaka University School of Medicine, *2Surgical Intensive Care Unit, National Cardiovascular Center |
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| Journal | Circulation Control |
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| Volume | 18 |
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| Number | 3 |
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| Page | 409-413 |
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| Year/Month | 1997/ |
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| Article | Report |
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| Publisher | Japan Society of Circulation Control |
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| Abstract | Alpha-human atrial natriuretic peptide (hANP), a new potent vasodilating and diuretic drug whose mechanism is different from those of commonly prevailing diuretics, can be effective in the cases which do not respond to the conventional diuretic therapy. Here, we experienced 2 cases which had been treated with a long-term intravenous infusion of hANP and became oliguric just after the discontinuance of low dose hANP infusion. We compared renal function and natriuretic peptide system between before and after the termination of hANP infusion in these cases. The temination of hANP decreased a blood BNP concentration, concomitantly with a drop of blood ANP concentration, which led to a marked reduction in blood cGMP concentration. This concomitant drop of blood ANP and BNP concentration was considered to disturbe the function of renal tubules and result in oliguria. The discontinuance of hANP needs careful tapering in the cases of long-term hANP infusion. |
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| Practice | Basic medicine |
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| Keywords | hANP, BNP, cGMP, Oliguria |
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