男性急性颈髓损伤病人的水钠代谢紊乱及相关激素变化

Water and sodium imbalance and the changes of relative endocrine systems in male acute complete cervical spinal cord injury pa-tients

目的研究男性急性完全性颈髓损伤患者继发的水钠代谢紊乱及有关的内分泌变化,探讨颈髓损伤继发低钠血症的发生机制。方法男性颈髓损伤组(简称男性CSCI组)19例,男性对照组14例,研究其水钠代谢变化,放免检测血浆肾素活性(PRA)、抗利尿激素(ADH)浓度及血清睾丸酮浓度。结果与对照组比较,男性CSCI组血钠浓度降低,此外还有多尿、尿钠排出增多以及液体入量低于尿量等变化(P<0.05);CSCI组PRA、血浆ADH及血清睾丸酮浓度均低于对照组。结论男性颈髓损伤患者其伤后血清睾丸酮浓度下降,可能对其继发性的低钠血症有一定的促发作用。

Objective The purposes of present study are observing the clinical manifestations of water and sodium imbalances and in ves-tigating the changes of relative endocrine systems in male acute CSCI patient,and presume the role of testosterone in the mechanism of hy-ponatremia in male CSCI patients.methods Nineteen male acute complete CSCI ca ses were studied.Fourteen male case s were used as con-trol.We surveyed the clinical manif estations of water-sodium imbalance after acute CSCI.We also studied th e relative changes of plasma renin activity(PRA)and antidiuretic hormone(ADH)and serum testosterone radioimmunologically.Results In present study,for the male CSCI group,besides hyponatremia,polyu ria and hyper-natriuresis occurred compared with male control group with significant differences.In the ma le CSCI group,mean administration volume of fluid was lower than mean urine volume with significant difference s(P<0.05).The mean PRA,mean plasma ADH and serum testostero ne in the male CSCI group were lower th an those in male control group with significant differ-ences.Conclusion The decrease of serum testosterone might play an important role for the se condary hyponatremia in male CSCI patients.