Involvement of the Neuron-Endocrinium in Endogenous Sudden Death

为了阐明猝死时应激激素对心源性和呼吸性猝死的反应，利用大鼠，在有无脑缺血、主动脉狭窄等病变的情况下，比较了静注KCL致心脏骤停型猝死和静注SCC致呼吸暂停型猝死的死亡期和死亡后即刻的血和各脏器肾上腺皮质激素皮质酮(CS)、儿茶酚胺(CA)[肾上腺素(EP)、去甲肾上腺素(NE)、多巴胺(DA)]和环磷酸腺苷(CAMP)的测定值。在没有预先存在病变的所谓健康正常状态下，在无麻醉状态下引起心脏骤停优先或呼吸暂停优先的情况下，血液CS和CA(EP，NE)显示相当于呼吸性死亡的后者显著高值；肾上腺内CS和CA(EP，NE，DA)显示显著低的…对于后者，脑内CA(NE、DA)对猝死和心肌内CA均表现出近似值，尤其是NE对呼吸性死亡表现出极低的值。在无麻醉状态下发生脑缺血时，猝死时血CS和CA(EP、NE)呈现较高水平的呼吸性死亡，但对CA有显著差异，肾上腺内CS表现为低水平呼吸性死亡，CA表现为相同水平的猝死，脑内和心肌内CA的结果与健康正常条件下相同。脑内CA和NE对呼吸性死亡的诊断价值略高，心肌内CA与正常和脑缺血情况下的结果相同，仅心肌内cAMP对心源性死亡的诊断价值显著升高。上述结果表明，心脏骤停优先或呼吸暂停优先猝死时应激激素的动态变化因体液传递系统和神经传递系统的不同而呈现明显不同的方面，并取决于是否存在任何先前存在的脑或心脏病变。提示肾上腺内和心肌内应激激素及其相关物质的定量分析作为猝死发病机制的线索，使心源性和呼吸性死亡的鉴别成为可能。较少

With a view to elucidating the response of stress hormone at sudden death to heart death and respiratory death and using rats, cardiac arrest-preceding type sudden death due to intravenous injection of KCL and apnea-preceding type sudden death due to intravenous injection of SCC were comparatively examined for measured values at agonal stage or immediately after death under condition of the existence or otherwise of such lesions as cerebral ischemia and aortic stenosis with respect to adrenocortical hormone such as corticosterone(CS), catecholamines(CA)[epinephrine(EP), norepinephrine(NE), dopamine(DA)] and cyclic AMP in blood and various organs. In case of the cardiac arrest-precedence or apnea-precedence caused under non-anesthesia in the so-called healthy normal condition without pre-existent lesions, blood CS and CA (EP, NE) showed significantly high values for the latter precedence equivalent to respiratory death; intraadrenal CS and CA (EP, NE, DA) showed significantly low values … More for the latter precedence, intracerebral CA (NE, DA) showed approximate values for both sudden deaths and intramyocardial CA and especially NE showed remarkably low values for respiratory death. In case of cerebral ischemia under non-anes-thesia, blood CS and CA (EP, NE) at sudden death tended to show higher level of values for respiratory death, but with a significant difference for CA; intraadrenal CS showed contrariwise low level of values for respiratory death, CA showed the same level of values for both sudden deaths and intracerebral and intramyocardial CA gave the same results as in healthy normal condition.In case of aortic stenosis as cardiac dysfunction under non-anesthesia, blood CS and CA and intraadrenal CS and CA gave the same results for both sudden deaths as in case of cerebral ischemia; intracerebral CA and especially NE showed slightly high values for respiratory death, an intramyocardial CA gave the same results as in healthy normal condition and in case of cerebral ischemia.Only intramyocardial cyclic AMP showed significantly high level of values for heart death. The above results revealed that the kinetics of stress hormone at sudden death due to cardiac arrest-precedence or apnea-precedence showed remarkably different aspects according to the humoral transmission system and the neural transmission system and depending upon the existence or otherwise of any pre-existent cerebral or cardiac lesion and suggested that quantitative analysis of intraadrenal and intramyocardial stress hormone and its related substance as a clue to the pathogenesis of sudden death made it possible to differentiate heart death from respiratory death. Less