[Concentration of pituitary-thyroid system hormones in the blood of patients with chronic circulatory insufficiency].
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Biomedical subjects
Publications and source records attributed to V P Masenko.
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Secretions of hormones responsible for carbohydrate metabolism, STH, insulin, S-peptide and somatostatin, were measured in coronary patients in order to investigate hormonal mechanisms involved in disordered carbohydrate metabolism. A persistent hyperinsulinemia was found in patients with disordered carbohydrate metabolism, both in cases of glucose stimulation and insulin inhibition, where glandular function was assessed on the basis of S-peptide concentration as opposed to the control level. Baseline somatostatin concentrations were beyond the method's sensitivity limit in most of the patients. There was a tendency to elevated hormonal levels in the insulin test, whereas glucose administration produced an opposite response. Blood basal STH levels did not differ significantly in the study groups, however the increase in hormonal secretion following insulin administration was less pronounced in patients with disordered carbohydrate metabolism as compared to other groups.
Captopryl was used in 30 patients with different clinical forms of arterial hypertension (AH). Eight patients had the malignant arterial hypertension syndrome. Blood pressure became normal in 8, decreased in 9 and did not respond to hypotensive treatment in 2 patients. The drug was discontinued due to intolerance in 1 patient. In the course of captopryl treatment, natriuresis increased, potassium concentration increased in the plasma and decreased in the urine, plasma renin activity and aldosterone level increased. Minoxidil was used in 48 patients with AH of varying clinical forms, 19 of those having the malignant AH syndrome. The hypotensive effect of treatment was satisfactory. Minoxidil used as the sole therapeutic agent resulted in increased heart rate and plasma renin activity, and retention of fluids, which disappeared after beta-adrenoblockers and diuretics were added. Patients with the malignant hypertension syndrome showed a reduction, and sometimes disappearance, of retinal ischemic and hemorrhagic foci within 15-19 days of minoxidil treatment, or at the end of the treatment course with captopryl.
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The corticotropic function of the adenohypophysis was investigated in patients with essential hypertension considering the stage of the disease and development of crisis. There was found functional activation of the system under study at the labile stage of essential hypertension without crisis as well as in patients with crisis at labile and stable stages of the disease. Unidirectional shifts were observed in the function of the vasopressor part of the hypothalamus-neurohypophyseal system.
Plasma renin activity (PRA) under basal conditions was determined in 64 patients with circulatory failure of various etiology by the radioimmunoassay. PRA in 50 patients was normal. Among 33 patients with severe circulatory failure, PRA was normal in 19 patients (Group 1) and high in 14 (Group 2). The patients of the two groups did not differ in sex, age and stage of circulatory failure. However, in the first group, a combined treatment with cardiac glycosides, diuretics and peripheral vasodilators proved to be efficacious in 18 out of 19 patients while in the second group 7 out of 14 patients died in spite of the therapy.
Seventy-eight patients with myocardial infarction had been admitted to the intensive care unit not later than 5 h after the beginning of illness. The levels of myoglobin, CPK, LDH, AST, ALT, MB CPK and LDH1 were determined in the blood serum of the patients in the time course during the first 24 hours of hospitalization. All patients showed considerable increase of myoglobin level in the blood serum. In myocardial infarction the level of myoglobin is enhanced significantly earlier than all the other indices, and reached its maximum figure also earlier. In the majority of cases its content reverts to normal at the beginning or in the middle of the second day. In 10 patients with the spread of the primary focus of lesion a repeated peak of myoglobin rise was recorded a few hours after the painful attack. In cases complicated during the course of illness by circulatory insufficiency hypermyoglobinemia was observed during a much greater period of time. Hypermyoglobinemia is the most sensitive and the earliest test of myocardial infarction compared to other biochemical tests.
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The blood concentration of the thyroid hormones, thyroid stimulating hormone and lipids were estimated in 67 patients with ischemic heart disease (IHD), 12 patients with hypothyroidism (H) and 19 normal controls. H was diagnosed in 9% of the patients with IHD. There were similar changes of the blood lipid concentrations in the patients with IHD (without H) and the patients with H (without IHD): increased level of the total cholesterol, triglycerides, cholesterol of the low and very low density lipoproteins. The blood level of cholesterol of high density lipoproteins (C-HDL) was significally higher in the patients with H than in the patients with IHD. There was correlation of the level of thyroxine in the blood and clinical severity of angina pectoris among the euthyroid patients with IHD having the same degree of coronary atherosclerosis.
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