泌尿器科領域におけるtrans-AMCHA大量投与の経験

Abstract

One of the purposes of this report is to study whether the large dose of trans-AMCHA is effective or not against renal bleeding resistant to treatment with ordinary doses of hemostatics. Another is to check the changes in fibrinolytic and coagulating systems by the treatment. Twelve cases with hematuria received 6, 000 mg of trans-AMCRA per day from 3 to 8 days. It was administered orally to 8 cases of renal hemorrhage due to nephroptosis or idiopathic cause, and was given intravenously to other 4 operated cases. The results of routine hematological study and studies on the clotting system and fibrinolysis before the treatment were normal in all of the subjects. Trans-AMCRA markedly suppressed the fibrinolytic activity of euglobulin and of plasma, but had little influence on the coagulation process. The fibrinogen level decreased by trans-AMCRA in the half of those with renal hemorrhage, and was not altered in another half, while it increased markedly in the operated cases probably due to the surgical involvement. Reduction of FDP levels was detected in 2 of 4 cases in whom FDP levels had been high before trans-AMCRA administration. Trans-AMCRA in a daily dose of 6, 000 mg was clinically effective in 6 of 8 cases with renal hemorrhage and in all of 4 operated. As regard to the side effects, 2 of the patients whom trans-AMCHA was administered intravenously complained of nausea during the injection, which was readily managed by decreasing the dripping rate. Another patient having trans-AMCRA capsules complained of anorexia, which disappeared by cessation of the drug.