蛛网膜下腔出血时血浆心钠素与低钠血症的关系

Study on the relationship between atrial natriuretic peptide and hyponatremia after subarachnoid hemorrhage

目的 研究蛛网膜下腔出血 (SAH)后血浆心钠素 (ANP)的水平变化及其与SAH后低钠发生的相关性。方法 采用放射免疫分析技术和离子选择性电极法检测 2 6例SAH患者不同病程的血浆ANP水平和血清钠水平。根据血清钠水平将 2 6例SAH患者分为SAH低钠组和SAH正常钠组 ,与健康对照组的血浆ANP水平进行比较。结果 SAH低钠组发病后 0～ 3d ,7～ 9d ,14～ 16d的血浆ANP水平均显著高于健康对照组 (P <0 0 1) ,且发病 7～ 9d ,14～ 16d的血浆ANP水平高于SAH正常钠组 (P <0 0 1) ;SAH低钠组血浆ANP水平与血清钠之间呈显著负相关。结论 血浆ANP参与SAH后低钠血症的发生 ;临床上对于SAH后血浆ANP水平显著高值的患者 。

Objective To investigate the plasma concentration of ANP and its relationship with hyponatremia following SAH. Methods The concentrations of plasma ANP and serum sodium were measured by radioimmunoassay in 26 patients at 0 to 3 days,7 to 9 days and 14 to 16 days after SAH. 26 patients were divided into hyponatremic group and normonatremic group according to the serum sodium concentrations.The plasma ANP concentrations were measured by radioimmunoassay in 15 healthy people as control.ANP concentrations were compared among hyponatremic group,normonatremic group,control group and the relationship between plasma ANP and serum sodium concentrations was analysed in hyponatremic group.Results Plasma ANP concentrations of hyponatremic group at 0 to 3 days, 7 to 9 days and 14 to 16 days after SAH were much higher than those of control group (P<0.01)Plasma ANP concentrations of hyponatremic group at 7 to 9 days and 14 to 16 days after SAH were higher than those of normonatremic group (P<0.01).There were negative correlations between plasma ANP concentrations and serum sodium concentrations in hyponatremic group.Conclusion These results suggest that ANP may play a role in the development of hyponatremia following SAH.If a patient had high level of plasma ANP after SAH,attention should be paid to the development and worsening of hyponatremia.