急性颈脊髓损伤后低钠血症的发病机制研究

Study on Pathogenesis of Hyponatremia from Acute Cervical Spinal Cord Injury(ACSCI)

[目的]探讨急性颈脊髓损伤(acute cervical spinal cord injury,ACSCI)后低钠血症(hyponatremia)的发病机制及其危险因素。[方法]选择2009年10月至2012年10月在我院骨科诊断为ACSCI的住院患者86例,按是否并发低钠血症分为低钠组和对照组。分析两组间不同的临床特点。[结果]两组患者脊髓损伤平面比较无统计学差异(P>0.05),低钠组完全性脊髓损伤多于对照组(P<0.05);低钠组患者平均心率、平均收缩压、平均舒张压、平均血钠、血氯及血钙水平均低于对照组(P<0.05),而平均24h尿量多于对照组(P<0.05)。Logistic逐步回归分析结果显示低钠血症与患者脊髓损伤程度明确相关。[结论]交感神经系统(sympathetic nervous system,SNS)受抑制是ACSCI后低钠血症的发病机制之一。脊髓损伤程度越高,低钠血症发生率越高。

[Objective] To discuss the pathogenesis and risk factors of hyponatremia from ACSCI.[Method] Select 86 of such cases,divide them into low-sodium group and control group;analyse the different clinical features between the 2 groups.[Result] There＇s no difference of statistical meaning on comparison of spinal cord injury,low-sodium group was more than other group on complete spinal injury;average heart rate,systolic pressure,diastolic pressure,blood sodium,blood chlorin and blood calcium in low-sodium group were all lower than control group,while the 24-h urine volume was more than control group.The Logistic stepwise regression analysis showed hyponatremia was definitely related with spinal cord injury.[Conclusion] The inhibited sympathetic nervous system（SNS） is one of pathogenesis of hyponatremia after ACSCI;the more severe of the spinal injury,the higher rate is the hyponatremia.