早产儿抗利尿激素对肾功能的影响

The Effect of Antidiuretic Hormone to Renal Function in Preterm Infants

目的 :探讨早产儿抗利尿激素 (ADH)对肾脏功能的影响。方法 :早产儿 30例 (观察组 ) ,足月儿 2 5例 (对照组 ) ,以FM 6冰点渗透压仪检测血浆、尿液渗透压。放射免疫法检测ADH。全自动生化分析仪测定血钠、尿钠、血肌酐、尿肌酐及血尿素氮 ,计算出钠排泄分数 (FENa)、肌酐清除率 (Ccr)、自由水清除率 (CH2 O)。结果 :观察组与对照组ADH分别为 8.12± 2 .6 1,5 .13± 1.2 9ng/L ,有显著差异 (P <0 .0 5 )。ADH与FENa正相关 (r :0 .5 78,P <0 .0 1) ,与血渗透压负相关 (r : 0 .4 75 ,P <0 .0 5 )。结论 :早产儿胎龄越小 ,肾小球滤过率越低 ,钠排泄分数越高。ADH对早产儿肾脏水盐代谢的调节有限 。

Objective: To investigate the effect of antidiuretic hormone (ADH) to renal function in preterm infants. Methods: 30 preterm infants(study group) and 25 term infants(control group) were studied. Osmolarity of plasma and urine were measured by FM-6 pattern freezing point osmometer, ADH in serum were detected by radioimmunoassay, blood and urine sodium, blood and urine creatine, blood BUN, fractional sodium excretion (FENa), creatine clearance (Ccr), clearance of free water(CH 2O)were also detected.Results: The ADH of study group and control group were 8.12±2.61,5.13±1.29 (ng/L) respectively and there was significantly difference between two groups (P<0.05). ADH was positive correlated to FENa(r:0.578,P<0.05) and negative correlated to plasma osmolarity (r: -0.475,P<0.05). Conclusion: The smaller of gestational age in preterm infants, the lower of glomerular filtration rate and the higher FENa. The regulation effect of ADH to metabolism of water and sodium in preterm infants was limited and may be caused by renaltubular responsing bluntly to ADH.