尿酸测定在两种脑性低钠血症中的作用

Effect of uric acid on inappropriate secretion of antidiuretic hormone and cerebral salt wasting syndrome

目的探讨尿酸测定在两种脑性低钠血症:抗利尿激素分泌异常综合征(the syndrome of inappropriate antidiuretic hormone secretion,SIADH)和脑性耗盐综合征(the cerebral salt wast-ing syndrome,CSWS)中的作用。方法把22例颅内疾病并SIADH作为A组,定期监测血清钠浓度,待血钠正常的恢复期患儿设为B组,并把12例颅内疾病并CSWS设为C组,其恢复期作为D组,同时监测其血尿酸、血清抗利尿激素(ADH)、心钠素(ANP)浓度,并监测血渗透压、尿渗透压及尿钠等。结果A组患儿的血尿酸与B组相比差异有统计学意义(P<0.01),A组的血尿酸水平明显低于B组,C组患儿的血尿酸与D组相比差异无统计学意义(P>0.05),C组的血尿酸水平与D组相似,A组患儿的血尿酸与C组相比差异有统计学意义(P<0.01),A组的血尿酸水平明显低于C组。结论颅内疾病并发SIADH患儿的血尿酸水平明显低于恢复期及并发CSWS的患儿,临床上对颅内疾病并发SIADH或并发CSWS的诊断起参考作用。

Objective To investigate the effect of uric acid on syndrome of inappropriate secretion of antidiuretic hormone （SIADH） and cerebral salt wasting syndrome （ CSWS）. Methods The 22 cerebral diseases with SIADH were chosen as A group, the patients during the recovery time were chosen as B group and the 12 cerebral diseases with CSWS were selected as C group, and the patients during the recovery time were chosen as D group. Serum sodium, uric acid, ADH, ANP, plasma osmotic pressure, uri- nary sodium and osmotic pressure were detected in all the patients. Results Serum uric acid was significantly lower in A group than in B group and in C group. Serum uric acids in C group were similar to those in D group. Conclusion Serum uric acid in the SIADH was significantly lower than in the patients during recovery time and in the patients with the CSWS, it helps us distinguish the CSWS from the SIADH.