心钠素、抗利尿激素在正常和缺氧新生儿水钠代谢中的作用

Effect of atrial natriuretic peptide and antidiuretic hormone on metalism of fluid and natriumin in normal and hypoxic newborns

为了阐明心钠素（ANP）和抗利尿激素（ADH）在正常和缺氧新生儿生后早期体液平衡中的作用，测定了44例正常新生儿和36例缺氧新生儿生后第1、3、7天血浆心钠素（PANP）、抗利尿激素（PADH）以及血、尿各项指标。结果表明：正常新生儿生后第1天PANP和PADH都升高，两者之间存在着负相关关系；尿量、尿钠、尿渗透压和ANP呈正相关；缺氧新生儿的PANP和PADH均较正常儿升高，其第3天的尿量、尿钠和尿渗透压均显著高于正常新生儿同期水平，提示ANP在新生儿早期水钠平衡中起主要作用，ANP通过明显的排钠利尿代偿了由ADH所致的水潴留，有助于缺氧新生儿肺功能的恢复和肺水肿的吸收。

In order to study the fluid homeostasis in hypoxic newborns, plasma natriuretic peptide (PANP), an-tiuretic hormone (PADH) and other parameters related to fluid and salt metabolism on the lst, 3rd and 7th day of lifewere measured in 36 cases of hypoxic newborns, compared with 44 cases of normal newborns. The results indicated thaton the lst day of life of normal nweborns, the values of PANP and PADH are increased. The 1evels of PANP, but notof PADH, were positively related to those of urinary volume, sodium, and osmolality. In hypoxic newborns, bothPANP and PADH levels on the lst day of life were higher than those of normal newborns, the values of urinary volume,sodium and osmolality on the 3rd day of life were also higher than those of normal newborns. These data suggest thatANP and ADH may play an important role in balance of fluid and electrolyte in early newborns. The potent diuretic andnatriuretic responses of ANP compensate the fluid retention resulted from increased levels of ADH, and then it helps im-prove the recovery of pulmonary function and absorption of pulmonary edema in hypoxic newborns.