急性颈髓损伤后的低渗血症与内分泌改变的关系

Hyposmolality in Acute Cervical Spinal Cord Injury and Its Relation

目的 本文通过对水盐代谢相关激素 :抗利尿激素、醛固酮、心钠素进行测定 ,探讨低渗血症形成的内在原因。方法 自 1999年 9月～ 2 0 0 2年 3月对颈髓损伤组共 5 2例 ;对照组 12例 ,共 6 4例进行醛固酮、抗利尿激素、心钠素的测定。结果 醛固酮浓度、心钠素浓度、抗利尿激素浓度与血浆渗透压相关。颈髓损伤不同平面其血醛固酮浓度、心钠素浓度、抗利尿激素浓度无显著性差别 (P >0 0 5 )。结论 急性颈髓损伤并发的低渗血症与血液抗利尿激素、心钠素浓度增高。

Objective This study is to explore the cause of the high occurrence rate of the hyposmolality in acute cervical spinal cord injury by measurement of aldosterone,anti-diuretic hormone and atrial natriuretic factor in blood.Methods Sixty-four patients admitted between September,1999 and March,2002 with acute spinal cord injury were studied through measurement of aldosterone, anti-diuretic hormone and atrial natriuretic factor in blood.Of the patients , 52 cases suffered from acute cervical spinal cord injury,12 were fracture patients but no spinal cord injury.Results The high occurrence rate of the hyposmolality in acute cervical spinal cord injury were caused by higher concentrations of atrial natriuretic factor and anti-diuretic hormone and lower concentrationof aldosterone; There were no significant differences of aldosterone concentration, atrial natriuretic factor and anti-diuretic hormone concentration among patients with C 4,C 5 and C 6 wertebrae(P>0 05).Conclusion Hyposmolality in acute cervical spinal cord injury has relations with higher concentrations of atrial natriuretic factor and anti-diuretic hormone and lower concentrationof aldosterone.