腎疾患における心臓抑うつ因子

W H Hörl¹, W Riegel

¹Department of Internal Medicine, University of Saarland, Homburg, FRG.

Circulation

|May 1, 1993

まとめ

慢性および急性腎不全における心臓機能不全は,特定の心筋抑制因子から生じる可能性があります. 研究によると,これらの毒素は濾過可能であり,腎不全のタイプとセプシスによって異なります.

科学分野:

ネフロロジーはネフロロジーを用います.
心臓病学心臓病学
毒理学毒理学毒理学

背景:

慢性腎不全 (CRF) と急性腎不全 (ARF) は,心臓機能不全と関連しており,特にARFがセプシスを含む場合が特に顕著です.
CRFでは線維症が認められるが,機能性心筋病も発生する.
アセテート酸と二次性副甲状腺症は,尿血症における主要な心筋緩薬である可能性は低い.

研究の目的:

CRFおよびARFの患者における心筋収縮因子の存在と性質を調査する.
これらの因子の尿性心筋病変における潜在的な役割を調査する.
CRF,ARF,およびセプシスにおける抑うつ因子を区別するために.

主な方法:

透析を受けているCRFおよびARF患者の血清分数および超濾過物の分析.
カーニチンの欠乏症に関する研究から得られたデータの評価 (制御が不十分であることに留意した).
抑うつ剤物質の分子量を示唆する実験のレビュー.

主要な成果:

CRFおよびARF患者からの血清分子は,心筋抑うつ作用を示す.
多臓器不全における継続的血液濾過の利点は,これらの要因の役割を支持しています.
証拠は,CRF,ARF,およびセプシスにおいて異なる抑うつ因子が存在することを示唆しており,異なる分子量が提案されている (500-5,000 d,>10,000 d,および現在10,000-30,000 dと考えられている).

結論:

この研究は,濾過可能な毒素による腎不全における"特異性心筋病"の存在を確認した.
心筋の抑うつ因子は,尿血症と敗血症に存在します.
これらの要因は,CRF,ARF,およびセプシスにおいて異なっているようです.

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