대한핵의학회지 (1967년~2009년)
대한핵의학회지 1974;8(1)1~11
한국형 출혈열에서의 혈류역동학적 연구 ( Hemodynamics in Korean Hemorrhagic Fever )
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Author 한지영(Jie Young Han),이정상(Jung Sang Lee),고창순(Chang Soon Koh),이문호(Mun Ho Lee),
Affiliation
Abstract

The author in an attempt to evaluate hemodynamic changes in the clinical stages of Korean hemorrhagic fever measured plasma volume, cardiac output and effective renal plasma flow utilizing radioisoto as during various phases of the disease. Cardiac output was measured by radiocardiography with external monitoring method using RIHSA. Effective renal plasma flow was obtained from blood clearance curve drawn by external monitoring after radiohippuran injection according to the method described by Razzak et al. The study was carried out in thirty-eight cases of Korean hemorrhagic fever and the following conclusions were obtained. 1) Plasma volume was increased in the patients during the oliguric and hypertensive-diuretic phases, while it was normal in the patients during the normotensive-diuretic phase. 2) Cardiac index was increased in the patients during the oliguric phase and was slightly increased in the patients at the hypertensive diuretic phase. It was normal in the other phases. 3) Total peripheral resistance was increased in the hypertensive patients during diuretic phase, while it was normal in the rest of phases. 4) Effective renal plasma flow was significantly reduced in the patients during the oliguric and diuretic phases as well as at one month after the oliguric onset. There was no significant difference between the oliguric and the early diuretic phases. Renal plasma flow in the group of patients at one month after the oliguric onset was about 45% of the normal, however, it returned to normal level at six months after the onset. 5) Clinical syndrome of relative hypervolemia was observed in some patients during the oliguric phase or hypertensive diuretic phase. Characteristic hemodynamic findings were high cardiac output and normal to relatively increased peripheral resistance these cases. Relatively increased circulating blood volumes due to decreased effective vasculat space was suggested for the mechanism of relative hypervolemia. 6) Cardiac hemodynamic alteration returned to normal during late stage of the diuretic phase, while renal hemodynamic changes were normalizd at six months after the onset.

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