急性脑卒中与低钠、低氯血症关系及其临床意义

Relationship of hyponatremia and hypochloremia to acute cerebral apoplexy and clinical significance thereof

目的探讨低钠、低氯血症与急性脑卒中的病情轻重、卒中类型及其预后的关系。方法2005年6月至2006年12月我院收治的符合入选条件的急性脑卒中患者412例(出血性卒中179例,缺血性卒中233例),于入院次日、7天、14天晨检测空腹血钠、血氯。入院后24h内对患者的病情按改良Edinburgh-Scandinavia临床神经功能缺损程度评分标准进行评分,并分为轻型184例,中型145例,重型83例。结果出血性卒中组低钠、低氯血症的发生率明显高于缺血性卒中组;低钠、低氯血症组中的中、重度患者显著多于正常血钠、血氯组;低钠、低氯血症组死亡率也明显高于正常血钠、血氯组。差异均有统计学意义。结论低钠、低氯血症可以作为判断急性脑卒中病情、预后评估的指标。

Objective To investigate the relationship of hyponatremia and hypochloremia to acute cerebral apoplexy and clinical significance thereof.Methods 412 patients with acute cerebral apoplexy,179 with hemorrhagic apoplexy and 233 with ischemic apoplexy,were admitted from June 2005 to December 2006.Two,seven,and fourteen days after the hospitalization fasting blood samples were collected to detect the levels of serum natrium and chloride.Revised Edinburgh-Scandinavia nervous function scoring was used to assess the condition of the patients.Results Among the 412 patients 184 were diagnosed as of the mild type,145 were of the moderate type,and 83 of the severe type.The hyponatremia rate of the hemorrhagic apoplexy patients was 20.11% significantly higher than that of the ischemic apoplexy patients(14.59% P<0.05).The hypochloremia rate of the hemorrhagic apoplexy patients was 15.02%,significantly higher than that of the ischemic apoplexy patients(15.02%,P<0.05).The incidence rates of moderate type and severe type hemorrhagic apoplexy in those with hyponatremia and hypochloremia were significantly higher than those with normal serum natrium and serum chloride(all P<0.05).The mortality rates of the cerebral apoplexy patients with hyponatremia and hypochloremia were significantly higher than those patients with normal serum natrium and serum chloride(all P<0.05).Conclusion Hyponatremia and hypochloremia can be used as indicators of the severity and prognosis of acute stroke.