肺気腫の水分電解質代謝—特にNa＋について

Studies on water and mineral metabolism in pulmonary emphysema, with special reference to sodium ion.

緒言

　呼吸性酸塩基平衡障害にさいして細胞内外電解質に分布異常の生ずることが近時明らかにされ^1），又腎における水，電解質調節にも変動をきたすことが知られてきた^2）。一方細胞内外の水，Na^＋，K^＋分布維持が細胞のエネルギー消費活動によるといわれ^3），生体がO₂不足状態になつた場合には細胞内外の水，電解質に分布異常の起ることが見られる^4）。

　肺気腫の病態は，酸塩基平衡の面では動脈血CO₂分圧（PaCO₂）の上昇による呼吸性アシドーシスが特徴的であり，又動脈血O₂分圧（Pao₂）の減少が同時に見られること多く，組織のAno—xia状態が存在するものである。

Water and mineral metabolism was studied in 31 cases with pulmonary emphsema having no complication.

1) Compared with normal mean, the average of sodium and potassium concentration of arterial plasma were slightly elevated, and chloride slightly decreased. TBW and ICF were slightly increased,but ECF and I S F unchanged and. CPV and CBV were decreased in the body, fluid.

2) Respiratory acidosis with anoxemia was observed in most of the cases, but in some cases, me-tabolic acidosis was found with or without respiratory acidosis, and 1 case showed respiratoy alka-losis.

3) Elevated arterial concentration of sodium was observed in cases with elevated arterial PCO₂. Ho-wever, no correlation was seen between arterial blood pH and sodium concentration of arterial plasma. These results suggest that increase in sodium concentration of arterial plasma can be influenced by intracellular shift and renal regulation of body fluid.

4) Potassium concentration of arterial plasma was increased in cases with elevated arterial Pco₂.

5) Positive correlation between sodium concentration of arterial plasma and pressure in pulmonary artery, pulmonary capillary and vena cava. was observed.

6) Negative correlation was noticed between sodium concentration of arterial plasma and ECF, ICF and CPV.

7) Influence of anoxia was also indicated by changes in sodium and potassium concentration of arterial plasma, but this effect is considered to be less than that of arterial Pco₂.