垂体腺瘤和颅咽管瘤术后低钠血症的相关因素分析

Analysis of factors related to postoperative hyponatremia in patients with the pituitary adenomas or craniopharyngiomas

目的研究垂体腺瘤、颅咽管瘤病人术后糖皮质激素减量与低钠血症之间的关系。方法选取42例术后出现低钠血症患者为病例组,42例未出现低钠血症者为对照组,采用病例对照研究方法。为控制混杂因素,同时引入病人性别、年龄、肿瘤类型进行单因素和多因素分析。结果单因素分析显示,年龄对低钠血症发生的影响有统计学意义。将年龄纳入logistic回归方程的多因素分析提示年龄大于50岁是低钠血症发生的危险因素。糖皮质激素减量、性别、肿瘤类型对术后低钠血症发生的影响无统计学意义。结论年龄大于50岁是垂体腺瘤、颅咽管瘤术后低钠血症发生的危险因素之一,低钠血症的发生不能单用糖皮质激素的减量或者皮质醇水平低下来解释,而可能是多种因素综合作用的结果。

Objective To study the relationship between the hyponatremia and decrease in the glucocorticoid dose after the surgery for pituitary adenomas and craniopharyngiomas. Methods The case-control study was used. The case group included 42 patients with hyponatremia and the control group included 42 patients without hyponatremia after the surgery for the pituitary adenomas or craniopharyngiomas. The independent variables including the patients＇ sex and age, tumor types and decrease in the glucocorticoid dose were analyzed by logistic regression analysis. Results The logistic regression analysis showed that the patient＇ s age 〉50 years was an independent risk factor related to the hyponatremia after the surgery for the pituitary adenomas and craniopharygiomas （P〈0.01）, but the patient＇ s sex, tumor types and decrease in the glucocorticoid dose were not. Conclusions The age 〉 50 years is one of the risk factors related to the hyponatremia after the surgery for the pituitary adenomas and craniopharygiomas, which is not produced by the insufficient glucocorticoid dose or hypocortisolism and may be related to the comprehensive action of the many factors.