尿石症と自律神経機能 第II篇:尿石患者の血清K及びCa量について

Abstract

In paper I of this series the author reported that the function of the autonomic nervous system in urolithiasis was in the state of autonomic dystonia especially hypertonia of parasympathetic nervous system by the pharmacodynamic tests and mechanical tests. And then the hypertonic state of parasympathetic nervous system was more over recognized in post operative condition. In the present paper, in order to examine serum potassium and calcium levels related to the function of the autonomic nervous system, the author estimated in 20 urolithiasis both before and after the removal of calculous or affected kidney. Serum potassium and calcium levels were measured by the flame photometer. The results were as follows : 1) In 20 healthy adults (male 8, female 12), the average potassium value was 4.47± 0.29 mEq/L and that of calcium was 4.64±0.34 mEq/L and K/Ca-quotient was 0.96±0.11. 2) In 20 urolithiasis (male 17, female 3), the average potassium value was 4.25±0.43 mEq/L and that of calcium value was 5.05±0.91 mEq/L and K/Ca-quotient was 0.84±0.18. In urolithiasis the serum potassium levels lower than in healthy adults, on the other hand the serum calcium levels higher than in healthy adults, and then K/Ca-quotient tended to decrease. 3) Aft e r operative stress in urolithiasis the serum potassium level slightly tended to increase, and the serum calcium level transitiorily tended to decrease, and then K/Ca-quotient rose in slight degree. 4) 20 days after the removal of calculous or affected kidney, the serum potassium level rose in slight degree and the serum calcium level fell in slight degree, and then K/Ca-quotient have tendency to increase. 5) By the injection of adrena l i ne the serum potassium level in urolithiasis tended to increase, on the other hand the serum calcium level tended to decrease. K/Ca-quotient tended to increse. When pilocarpine was injected the serum potassium level tented to decrease and the serum calcium level tended to increase. K/Ca-quotient tended to decrease. These changes were still recognized after the removal of calculous or affected kidney. 6) In urolithiasis, those who had a high K/Ca-quotient were more likely to have sympathicotone adrenaline reaction on the curve of the blood pressure after adrenaline injection, and those with a low K/Ca-quotient were likely to have vagotone adrenaline reaction. From these results the author concluded that urinary stone-formation is many cases in state of autonomic dystonia especially hypertonia of parasympathetic nervous system upon electrolyte metabolism.