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[激素紊乱与难治性充血性循环功能不全的治疗]

[Hormonal disturbances and the treatment of refractory forms of congestive circulatory insufficiency].

作者信息

Korochkin I M, Matveeva I V

出版信息

Kardiologiia. 1976 Aug;16(8):36-43.

PMID:1011503
Abstract

In 109 patients with congestive circulatory insufficiency daily aldosterone excretion was examined by thin-layer chromatography, and in 50 patients aldosteronuria was compared with the excretion of electrolytes and haemodynamic parameters. The daily excretion of aldosterone under the effect of Prednisolone and other saluretics was studied along with the daily excretion of glucocorticoids under the effect of Prednisolone. The efficacy of a combination of drugs (Aldactone, Furosemid, Prednisolone) was studied in patients with refractory forms of circulatory insufficiency. The obtained data revealed an increase of the mineralocorticoid function and a decrease of the glucocorticoid function of the adrenals, a close correlation existing between the level of aldosteronuria, central haemodynamics pattern and electrolytes excretion. Therapy with Prednisolone results in a reduction of aldosteronuria, without causing any inhibition of the glucocorticoid function. The best therapeutic effect was obtained with a combination of Prednisolone, Aldactone, Furosemid, that caused distinct diuresis, natriuresis, increased blood plasma potassium levels, reduction of total dody fluid and body weight.

摘要

对109例充血性循环功能不全患者采用薄层色谱法检测每日醛固酮排泄量,并对其中50例患者的醛固酮尿与电解质排泄及血流动力学参数进行比较。研究了泼尼松龙及其他利尿剂作用下醛固酮的每日排泄量以及泼尼松龙作用下糖皮质激素的每日排泄量。对循环功能不全难治性患者研究了联合用药(安体舒通、速尿、泼尼松龙)的疗效。所获数据显示肾上腺盐皮质激素功能增强而糖皮质激素功能减弱,醛固酮尿水平、中心血流动力学模式与电解质排泄之间存在密切相关性。泼尼松龙治疗可降低醛固酮尿,且不会抑制糖皮质激素功能。泼尼松龙、安体舒通、速尿联合使用取得了最佳治疗效果,可引起明显的利尿、利钠作用,提高血浆钾水平,减少总体液量和体重。

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