Ionisiertes Kalzium: Seine Messungen Und Seine Kardiovaskulären Auswirkungen
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Kalzium hat in der Physiologie eine Schlüsselstellung und ist lebens- wichtig, es hat eine stabilisierende Wirkung auf erregbare Membrane, einen direkten Einflu auf die Membrandurchlässigkeit ftir Natrium und Kalium. Es steuert die Koppelung zwischen den elektrischen Ereignissen an der Zellmembran und der kontraktilen Funktion der Muskelzelle. Kalziumionen haben zudem eine direkte Wirkung auf die Sekretion von Katecholaminen, Insulin und Vasopressin. Sie beeinflussen ebenfalls direkt die Gefä permeabilität, die Effekte verschiedener Medikamente auf die Kontraktilität des Herzens und die Regulation des peripheren GeHi tonus. Mehrere Enzymsysteme können nur in Anwesenheit von Kalziumionen aktiviert werden. Daniel Scheidegger und Lambertus J. Drop, beide Schüler von Professor M. B. Laver, haben mit dem vorliegenden Buch einen gro en Beitrag geleistet zur Klariflzierung dieser rur die Klinik so wichtigen Zusammenhänge. Sie haben dazu interessante und schwierige Experimente durch- gefiihrt und sie mit gro er Sorgfalt analysiert. Die grö te Qualität dieser Arbeit, im Sinne und Geiste M. B. Laver's ausgeführt, liegt in der wissenschaftlichen Genauigkeit und Ehrlichkeit, sowie in der Klarheit der darausgezogenen Schlu folgerungen. Genf, im Mai 1984 Prof. Dr. M. Gemperle Inhaltsverzeichnis Einleitung . . . . . . . . . . . . . . . . . . . . . . . . .. . . . 1 . . . . . . Das kalziumselektive Elektrodensystem ............... 5 Die Ionenselektivität der Kalziumelektrode .. . . . . . . . .. . . 5 Wasserstoffionen .............................. 5 Natriumionen ................................ 6 Kaliumionen .. . . . . . . . . . . . . . . . . . . . . . .. . . . 6 . . . . . Magnesiumionen . . . . . . . . . . . . . . . . . . . . . .. . . . 6 . . . . . Anionen. . . . . . . . . . . . . . . . . . . . . . . . . .. . . 6 . . . . . . . Ionenaktivität oder Ionenkonzentration .. . . . . . . . . .. . . . 7 Normalwert der Konzentration des ionisierten Kalziums. . . .. 7 Faktoren, die die gemessene Konzentration des ionisierten Kalziums beeinflussen . . . . . . . . . . . . . . . . . . .. . . . 7 . . . . Kalziumionenkonzentration und das Q-T-Intervall im EKG . .. 12 Elektromechanische Koppelung durch Kalziumionen . . . . .. . 15 Transmembranöser Kalziumionenflu . . . . . . . . . . . .. . . 15 . . Die inotrope Wirkung von Kalzium und seine Kinetik .... _. 15 Intrazellulärer Kalziumionenüberschu . . . . . . . . . . .. . . 17 . .
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