摘要
目的 研究急性完全性颈髓损伤患者继发的水钠代谢紊乱及血浆心钠素的变化 ,并探讨其发生机制。 方法 选择 1998年 9月～ 2 0 0 0年 2月住院的骨科患者 ,分为颈髓损伤组 2 8例 ,对照组 18例。于不同时相点观察两组患者血清K+ 、Na+ 、Cl- 、二氧化碳结合力 (CO2 CP)、尿素氮 (BUN) ,以及尿量、2 4h尿Na+ 总排出量的变化 ;并采用放免法检测血浆心钠素浓度的变化。 结果 颈髓损伤组 92 .9% (2 6 2 8)出现低钠血症 ,且血Na+ 为 (132 .70± 3.2 0 )mmol L ,低于对照组(P <0 .0 1) ;颈髓损伤组尿量 [(36 10± 76 1)ml d]及 2 4h尿Na+ 总排出量 [(4 73.7± 16 9.4)mmol d]均高于对照组 (P <0 .0 1和P <0 .0 5 ) ;血浆心钠素浓度 [(0 .2 88± 0 .140 )ng ml]低于对照组 (P <0 .0 5 )。 结论 急性完全性颈髓损伤后常常继发低钠血症 ;颈髓损伤后交感神经抑制及低钠血症是引起血浆心钠素浓度降低的原因 ;
Objective To observe water electrolyte imbalance and investigate the changes of plasma concentration of atrial natriuretic factor (ANF) in acute cervical spinal cord injury (CSCI) patients. Methods Twenty eight acute complete CSCI patients were studied. Eighteen cases were used as controls. We observed the changes of blood electrolyte concentrations, the volume of urine, the volume of fluid transfusion and sodium in the urine. We also studied the changes of plasma ANF radioimmunologically. Results Hyponatremia occurred in 92.9% patients of the CSCI group. The concentration of serum sodium(132.70± 3.20 mmol/L) was lower in the CSCI group than that in the control group ( P <0.01). In the CSCI group, besides hyponatremia, polyuria(3 610±761 ml/day) and hyper natriuresis(473.7±169.4 mmol/day) occurred, there were significant difference compared with the control group respectively ( P <0.01,0.05). At the same time, The mean concentration of plasma ANF[ (0.288 ± 0.140) ng/ml] was lower in the CSCI group than that in the control group with significant differences ( P <0.05). Conclusions (1)Hyponatremia is a very common complication in acute complete CSCI patients. (2)Inhibition of sympathetic system and hyponatremia after acute CSCI is the cause of decrease of plasma ANF concentration. There is a little difference in the mechanism between hyponatremia after acute CSCI and cerebral salt wasting syndrome of brain disease although they are very similar.
出处
《中华创伤杂志》
CAS
CSCD
北大核心
2001年第8期460-462,共3页
Chinese Journal of Trauma
关键词
颈髓损伤
水电解质失调
血浆
心钠素
低钠血症
Cervical vertebrae
Spinal cord injuries
Water electrolyte imbalance
Hyponatremia
Atrial natriuretic factor
