急性颅脑损伤后血Na^+及相关激素变化的临床研究

Clinical significance of serum Na^+ and relative hormone ADH,ANP,Cortisol,ALD in acute head injury

目的 探讨血抗利尿激素 (ADH)、皮质醇 (Cortisol)、心钠素 (ANP)、醛固酮 (ALD)变化在急性颅脑损伤 (ACI)中的意义及其对血钠的影响。方法 对 2 0 0 2年 3～ 9月收治的 72例ACI患者血中ADH、ANP、Cortisol、ALD浓度及血清Na+ 、K+ 、Cl-、Ca2 + 进行同步监测。结果 ACI患者血ADH、Cortisol浓度显著高于对照组 ,血ANP浓度显著低于对照组 ,随病情进展 ,血ADH、Cortisol浓度增高显著高于伤后早期 ,血ANP的浓度显著低于伤后早期。结论 ACI导致下丘脑—垂体—肾上腺轴功能障碍 ,机体存在有效的调节代偿机制而不致发生严重的电解质紊乱 ,脑外伤越重 ,机体调节代偿功能越差。

Objective In order to elucidate the clinical significance of changes of blood ADH,ANP,ALD,cortisol levels and their effect on blood Na + level in acute craniocerebral injury.Methods The changes of atria natriuretic polypeptide(ANP) antidiuretic hormone(ADH),aldosterone(ALD),cortisol and serum Na +,K +,Cl -,Ca 2+ were observed in 72 patients with ACI.Results In ACI patients,the concentrations of blood ADH and cortisol were statistically higher and the concentration of ANP was statistically lower, compared with control.After 3～7 days of head injury,the concentrations of blood ADH and cortisol were statistically higher than those just after head injury.The ANP concentrations was statistically lower than that just after head injury.Conclusion Disorder of hypothalamic-hypophysial system was common in ACI patients but organism could regulate it in some ways.Serious hypernatremia or hyponatremia was rare.When head injury became serious,this kind of regulation became weak.