足月新生儿缺氧缺血性脑病患儿脑脊液Na^+、游离Ca^(2+)含量的分析

The significance of changes of Na^+ and Ca^(2+) in cerebrospinal fluid in neonate with Hypoxic ischemic encephalopathy

目的 探讨足月新生儿缺氧缺血性脑病(HIE)患儿脑脊液钠离子(Na+ )、游离钙离子(Ca2+ )含量的变化与HIE脑损伤程度之间的关系。方法 采用全自动电解质分析仪检测脑脊液Na+、游离Ca2+水平。结果 中、重度HIE组患儿急性期脑脊液Na+、游离Ca2+含量与对照组比较明显降低(P<0. 05、P<0. 01 ),而轻度HIE组和治疗后恢复期组与对照组比较,脑脊液Na+、游离Ca2+水平虽有降低,但组间差异无显著性(P>0. 01、P>0. 05)。13例中、重度HIE组的急性期患儿治疗后恢复期与治疗前比较,脑脊液及血浆游离Ca2+上升幅度明显高于Na+,其中血浆游离Ca2+上升幅度明显高于脑脊液游离Ca2+。结论 HIE患儿病情越重脑脊液中Na+、游离Ca2+越低,反之病情好转,脑脊液Na+、游离Ca2+有上升趋势。

Objective To investigate the relationship between changes in cerebrospinal fluid (CSF) sodium (Na^+) and calcium (Ca^(2+)) concentrations and the degree of brain impairment in neonate with hypoxic ischemic encephalopathy (HIE). Methods The concentrations of Na^+ and Ca^(2+) in CSF were detected by automatic electrolyte assay. Results The concentrations of CSF Na^+ and Ca^(2+) in middle and severe HIE group decreased significantly compared to controls (P<0.05 and P<0.01 respectively). But there was no significant difference between light HIE group, recovered group after treatment and control group. The levels of CSF and plasma Ca^(2+) increased more significantly than Na^+. Whereas the levels of Ca^(2+) in plasma increased more than it in CSF in 13 middle and severe HIE patients recovered period compared to before treatment. Conclusions Changes in the levels of CSF Na^+ and Ca^(2+) could be an index to evaluate the condition of neonatal HIE. Especially the changes in the levels of CSF Ca^(2+) could be an objective index.