心房钠尿肽与急性颈部脊髓损伤后低钠血症的相关性  

Relationship between atrial natriuretic peptide and hyponatremia in acute cervical spinal cord injury

作　　者：尚明富[1] 冯飞 祁健[1] SHANG Ming-fu;FENG Fei;QI Jian(Department of Spinal Cord Injury,the General Hospital of Jinan MilitaryRegion（former）of PLA,Jinan,Shandong 250031,China)

机构地区：[1]济南军区总医院脊髓修复科,山东济南250031 [2]栖霞市人民医院外2科,山东烟台265300

出　　处：《实用医药杂志》2018年第8期683-687,691,共6页Practical Journal of Medicine & Pharmacy

基　　金：原济南军区总医院院长基金课题(2016ZX02)

摘　　要：目的探讨心房钠尿肽(atrial natriuretic peptide,ANP,简称心房肽)分泌异常与急性颈部脊髓损伤(acute spinal cord mjury,ASCI)后低钠血症(hyponatremia,HN)的关系,及ANP在HN发生过程中可能的作用机制,为临床上预防、诊断和治疗HN提供依据和参考。方法用放射免疫法研究14例ASCI并HN患者血浆ANP的分泌量,与21例ASCI不伴HN患者及18例正常同龄组的血浆ANP分泌量进行比较,并检测血钠、24 h尿钠总量及24 h尿量。结果 (1)ASCI伴HN者,其血浆ANP水平较不伴HN者及正常对照组显著升高(P<0.05);(2)ASCI急性期血浆ANP水平与ASCI程度密切相关,ASCI越重,ANP水平越高,ANP水平越高,血钠越低,二者呈负相关(r=-0.84,P<0.05);(3)血浆ANP浓度越高,尿钠总量也越高,二者成明显的正相关(r=0.81,P<0.05);(4)血浆ANP浓度越高,尿量也越高,二者成明显的正相关(r=0.82,P<0.05)。结论 ASCI后HN患者ANP分泌异常增多,ANP分泌增加可能是导致ASCI后HN的一个重要因素。Objective To explore the relationship between inappropriate secretion of atrial natriuretic peptide（ANP） and hyponatremia in acute cervical spinal cord injury（ASCI）,so as to provide the theoretical basis for prevention,diagnosis and therapy of hyponatremia after acute spinal cord injury. Methods The plasma ANP of the candidates（14 cases of ASCI accompanied with hyponatremia,21 cases of ASCI without hyponatremia,18 cases of normal） were detected with radioimmunoassay（RIA）. The serum sodium,urinary sodium of a day and urinary volume of a day were tested. Results 1）The plasma ANP level of the ASCI patients with hyponatremia was significantly higher than that of the ASCI patients without hyponatremia and the normal. 2）The level of the plasma ANP was closely associated with the degree of ASCI. The severer the ASCI was,the higher the ANP level was,and the lower the serum sodium was. The plasma ANP was negatively associated with the serum sodium. 3）The higher the plasma ANP was,the higher the total urinary sodium was. The plasma ANP was positively associated with the total urinary sodium. 4）The higher the plasma ANP was,the higher the total urinary volume was. The plasma ANP was positively associated with the total urinary volume. Conclusion The secretion of the plasma ANP of the ASCI patients with hyponatremia is significantly abnormal. The increase of the ANP may be an important predisposition of the hyponatremia in ASCI.

关 键 词：心房钠尿肽 急性颈部脊髓损伤 低钠血症 

分 类 号：R651.2[医药卫生—外科学]