低钠血症细胞外液治疗量与骨钠分布量的函数关系  

Function formula of extracellular fluid sodium versus bone sodium in treatment of hyponatremia

作　　者：苏亚荣 李智超 任晶晶[1] 韩子岩[1] SU Yarong;LI Zhichao;REN Jingjing;HAN Ziyan(Department of Gastroenterology,Second Clinical Medical College,Shanxi Medical University,Taiyuan 030000,China)

机构地区：[1]山西医科大学第二医院消化科,太原030000

出　　处：《山西医科大学学报》2021年第7期909-914,共6页Journal of Shanxi Medical University

摘　　要：目的研究不同低钠血症新增细胞外液治疗量与新增骨钠量的函数关系。方法收集2005年1月至2019年1月于山西医科大学第二医院住院并诊断缺钠性低血钠的成年患者,制定纳入标准和排除标准,最终入选62例。根据血清钠水平及症状分3组:轻度低血钠(125-135 mmol/L,有乏力和轻度食欲减退症状),中度低血钠(115-125 mmol/L,有倦怠、食欲不振和恶心症状),重度低血钠(≤115 mmol/L,有嗜睡或昏迷症状)。设新增细胞外液量为X(mmol),新增骨钠为Y(mmol),对计量变量X和Y进行正态分布检验和配对t检验;轻、中和重度低血钠计量资料新增骨钠量(Y)比较用多组间单因素方差分析;分析计量变量X和Y的最佳函数关系采用标准化残差和拟合比较回归系数F检验。结果X和Y样本服从正态分布,两样本配对t检验有显著性差异。多组间单因素方差分析显示轻、中和重度低钠血症组间新增骨钠(Y)均数比较有显著差异(P<0.0001),轻、中和重度低钠血症骨钠新增分布依次增加。X与Y散点图和标准化残差散点图均显示较好的集中同向趋势,拟合比较显示三次函数曲线拟合程度最好。低钠血症的治疗中新增细胞外液钠与新增骨钠分布函数为Y=121.133+0.472X-0.024X^(2)+0.000104X^(3)。结论低钠血症的治疗中新增细胞外液钠与新增骨钠分布的数据呈正态分布。低血钠补钠治疗中新增细胞外液钠与新增骨钠分布函数为三次函数曲线。重度低血钠补钠治疗中新增细胞外液钠轻微,新增骨钠显著;轻度低血钠补钠治疗中新增细胞外液钠显著,而新增骨钠轻微;中度低钠血症近似直线负相关。Objective To investigate the function formula between increment of extracellular sodium(X)and increment of bone sodium(Y)by intravenous NaCl supplement in the patients with mild,moderate or severe hyponatremia.Methods According to inclusion and exclusion criteria,a total of 62 inpatients with hyponatremia were elected.According to the serum sodium level and the symptoms,the patients were divided into mild hypothermia group(125-135 mmol/L of Na+level and symptoms of fatigue and mild inappetence),moderate hypothermia group(115-125 mmol/L of Na+level and symptoms of tiredness,anorexia and nausea),and severe hypothermia group(lower than 115 mmol/L of Na+level and symptoms of drowsiness or coma).X and Y were tested by normal distribution test and paired t test.Na+level was analyzed by one way ANOVA among mild,moderate and severe hyponatremia groups.Standardized residuals and fitting comparison regression coefficient F test were used to analyze the optimal functional relationship between X and Y.Results The distribution curves of X and Y were normally distributed.There was significant difference between X and Y by paired t test(P<0.05).The increment of bone sodium was significantly higher in severe hyponatremia patients than in mild or moderate patients(P<0.05),and also higher in moderate hyponatremia patients than in mild hyponatremia patients(P<0.05).The fitting of cubic function was the best.The function formula of Y with X in the hyponatremia patients treated by NaCl was expressed as Y=121.133+0.472X-0.024X^(2)+0.000104X^(3).Conclusion The increments of sodium in the extracellular fluid and bone sodium are characterized by normal distribution.The cubic function is the best fitting between X and Y.Y is higher than X in severe hyponatremia patients,and Y is lower than X in mild hyponatremia patients.There is a approximately linear negative correlation between Y and X in moderate hyponatremia patients.

关 键 词：低钠血症 细胞外液钠 骨钠 函数关系 

分 类 号：R589[医药卫生—内分泌]