垂体腺瘤患者围手术期血钠与血浆醛固酮、心钠素关系

Relationship between sodium in serum and ALD, ANP in plasma in patients with pituitary adenomas

目的研究垂体腺瘤患者血钠与血浆醛固酮(ALD)、心钠素(ANP)的变化,探讨手术后发生低血钠的原因,为低钠血症的预防及处理提供一种可行性方法。方法随机选择垂体腺瘤患者20例,分别测定术前及术后第一个24h尿钠丢失量及血清钠、血浆ALD、ANP含量。结果20例患者手术后血钠下降9例,其中2例发生低钠血症;该9例患者术后尿钠丢失量明显增加(P<0.05),血浆ALD分泌减少。11例患者术后血钠不下降,尿钠丢失量无明显变化,血浆ALD分泌增加。血浆ANP含量在手术前、后均高于正常对照组(P<0.05)。结论垂体腺瘤患者排钠因素占优势,尿钠丢失增加与血浆ALD代偿不足有关,是引起血钠下降主要原因之一。

Objective To study the change of sodium in serum and aldosterone （ALD）,amal natriuretic polypeptide （ANP） in plasma among 20 cases with pituitary adenoma and explore the reasons causing hyponatremia after operation to find out a feasible method to prevent and treat the hyponatremia. Methods 20 patients with pituitary adenomas were selected randomly and divided into 2 groups： decline or non-decline of sodium in serum, according to the comparison of sodium in serum, the measuration of sodium in urine and ALD,ANP in plasma before operation and at 24 h after operation. T-test was performed with SPSS software. Results There were 9 patients with decline of sodium in serum, among whom 2 cases have hyponatremia, and the 9 patients＇sodium in urine at 24 h after operation were much more than that before operation（P〈0.05）, the secretion of ALD reduced after operation. 11 cases with no decline of sodium in serum and urine, and the secretion of ALD in them rose after operation. Not only before operation, but also at 24 h after operation, the secretion of ANP in both groups was much more than that in normal people （P〈0.05）. Conclusion The rising of sodium excretion in urine is one of the major reasons causing hyponatremia after operation in patients with pituitary adenomas, related with insufficiency of ALD in plasma.