新生儿缺氧缺血性脑病心房利钠多肽血浆水平的检测及其与低钠血症的关系

Plasma level of atrial natriuret ic peptide and its relationship with hyp onatremia in neonatal hypoxic ischemic encepha lopathy

目的 :观察血浆心房利钠多肽 (ANP)在新生儿缺氧缺血性脑病 (HIE)中的变化及与低钠血症的关系。方法 :采用放射免疫法分别检测 49例 HIE足月儿在治疗前后及 2 0例正常足月儿血浆 ANP水平 ,同时测定血清钠浓度 ,并将 ANP与血钠作相关性分析。结果 :HIE组血浆 ANP水平明显高于对照组 (P<0 .0 1 ) ,HIE程度愈重 ,ANP水平愈高 ,HIE组治疗后血浆 ANP水平明显低于治疗前水平 (P<0 .0 0 1 ) ;血浆 ANP与血清钠浓度呈显著负相关 (r=- 0 .6632 ,P<0 .0 0 1 )。结论 :血浆 ANP可反映 HIE患儿脑损伤的程度和预后 ,并可影响新生儿 HIE水盐代谢 ,引起失钠性低钠血症。

Objective: To o bserve the change of the plasma level of atrial natriuretic peptide(ANP) and its re lationship with hyponatremia in neon atal hypoxic ischemic encephalopathy (HIE) Methods: P lasma level of ANP was measured by r adioimmunoassay in 49 full term neon ates with HIE and 20 normal neonates, and serum sodium concentration was d etected at the same time Results: Pl asma level of ANP in HIE was signifi cantly higher than that in control g roup ( P <0 01),and decreased markedly after treatment( P <0 001) The more s evere was HIE,the higher was plasma level of ANP There was a negative co rrelation between plasma level of AN P and serum sodium concentration( r =- 0 6632, P <0 001) Conclusion:Plasma le vel of ANP is related to the severit y of brain damage and prognosis in n eonates with HIE ANP may be involved in the water and salt metabolism,an d cause diluted hyponatremia in neon atal HIE