蛛网膜下腔出血后血浆心房钠尿肽与低钠血症及脑血管痉挛的关系  

Relationships among Cerebral Vasospasm Following Subarachnoid Hemorrhage and Atrial Natriuretic Peptide and Hyponatremia

作　　者：韩陈保[1] 刘洲[1] 王义刚[1] 黄贯中[1] 

机构地区：[1]广东医学院附属医院神经内科,广东湛江市524001

出　　处：《中国康复理论与实践》2006年第4期329-331,共3页Chinese Journal of Rehabilitation Theory and Practice

摘　　要：目的探讨血浆心房钠尿肽（ANP）与蛛网膜下腔出血（SAH）后脑血管痉挛（CVS）及低钠血症的关系.方法动态测定42例SAH患者发病后第1～3天和第7天、第14天的血浆ANP、血钠水平及颅内主要动脉的血流速度,分析三者间的关系.结果 42例SAH患者中,28例出现CSV,其血浆ANP水平高于对照组及无CVS者（P＜0.05）;CVS患者低钠血症发生率高于无CVS患者（P＜0.05）;SAH后第7天和第14天的血浆ANP水平与血钠浓度呈负相关（r 2=-0.778和r3=-0.653;P＜0.01和P＜0.05）;出血后第7天的ANP与大脑中动脉平均血流速度呈正相关（r3=0.702,P＜0.05）;病后第7天和第14天的大脑中动脉平均流速与血钠浓度呈负相关（r 2=-0.693和r 3=-0.653,均为P＜0.05）.结论 ANP可能导致了SAH后的低钠血症,并在早期CVS的发病机制中起重要的作用.Objective To explore the relationships among atrial natriuretie peptide （ANP） and cerebral vasospasm （CVS） following subarachnoid hemorrhage （SAH） and hyponatremia. Methods Plasma ANP levels and serum natrium and blood flow rate of intracal major arterial were assessed at different times （1 to 3 days, 7 days and 14 days after SAH） in 42 patients with SAH. Corre lation analysis was carried out among plasma ANP, blood sodium level and blood flow rate of intracal major arterial. Results 28 patients had CVS. Plasma ANP levels in CVS patients significantly elevated compared with non-CVS and control subjects （ P 〈70.05）. Hyponatremia in CVS patients also significantly elevated compared with non-CVS subjects （ P 〈 0.05）. Plasma ANP level had significant negative relationship with serum natrium level at the 7th day and 14th day （ r 2 =-0. 778, r 3 =-0. 653 ; P 〈0.01, P 〈0. 05） in SAH patients. Plasma ANP level had significant positive correlation with middle cerebral artery mean flow velocity on the 7th day （ r 3 = 0. 702, P 〈0.05） in SAH patients, Middle cerebral artery mean flow velocity had significant negative relationship with serum natrium level on the 7th day and 14th day （ r 2=-0. 693, r 3=-0. 653, both P 〈0.05） in SAH patients. Conclusion ANP might cause hyponatremis following SAH and play an important role in pathogenesis of earlier period CVS.

关 键 词：蛛网膜下腔出血 心房钠尿肽 低钠血症 脑血管痉挛 经颅多普勒 

分 类 号：R743.35[医药卫生—神经病学与精神病学]