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バソプレシン欠乏症は, сепティック・ショックの血管拡張に寄与する
D W Landry1, H R Levin, E M Gallant
1Department of Medicine, Columbia University, College of Physicians & Surgeons, New York, NY 10032, USA.
Circulation
|March 4, 1997
まとめ
セプティックショック患者は,低血圧素のレベルがあり,低血圧に寄与します. ヴァソプレシン投与は,これらの患者の血圧を効果的に上昇させます.
科学分野:
- クリティカルケア・メディシン
- エンドクリノロジー エンドクリノロジー
- 生理学 生理学とは
背景:
- セプティックショックには,全身血管拡張と低血圧が特徴です.
- 臨床的観察により,この血管拡張に寄与するバソプレシンの潜在的な欠乏が示唆されました.
研究 の 目的:
- セプティックショックの低血圧におけるバソプレシン欠乏の役割を調査する.
- バソプレシン投与がセプティックショック患者の血動力学を改善できるかどうかを判断する.
主な方法:
- セプティックショックと心臓発作ショックを受けた患者の血バソプレシン濃度測定.
- セプティックショックを受けた患者に外因的バソプレシンを投与し,血液動力学的反応をモニターした.
- 患者のサブセットで,バソプレシンの離脱と再投与の効果を評価した.
主要な成果:
- セプティックショックを受けた患者は,心臓発作ショックを受けた患者と比較して,プラズマバソプレシン濃度が有意に低下した.
- バソプレシン投与は,セプティックショック患者の動脈圧と全身的血管抵抗を増加させた.
- ヴァソプレッシン投与を中止すると,低血圧が発生し,これはヴァソプレッシン投与によって逆転した.
結論:
- 不適切な低バソプレシンレベルは,血管拡張性 сепティックショックの特徴であり,おそらくバロレフレクスの分泌が低下しているためである.
- バソプレシン欠乏症は,セプティックショックで観察される低血圧に寄与する.
- 外因的バソプレッシン (Vasopressin) は,セプティックショックにおける効果的な圧縮剤である.
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