摘要
目的：阐明急性颅脑外伤（ＡＣＩ）患者水盐失衡发生机制及寻找治疗新途径。方法：对６８例ＡＣＩ患者血中心钠肽（ＡＮＰ）、脑钠肽（ＢＮＰ）、内源性类洋地黄物质（ＥＤＬＳ）、抗利尿激素（ＡＤＨ）含量及血、尿渗透压，血、尿钠浓度作同步监测，并在ＧＣＳ≤８分的病例中行促甲状腺素释放激素（ＴＲＨ）刺激试验，观察血中ＡＮＰ、ＢＮＰ、ＥＤＬＳ、ＡＤＨ反应。结果：ＡＣＩ患者血ＡＮＰ、ＢＮＰ浓度显著低于对照组，血ＥＤＬＳ、ＡＤＨ浓度显著高于对照组。ＡＮＰ、ＢＮＰ浓度降低不受脑伤程度影响，而ＥＤＬＳ、ＡＤＨ浓度升高与脑伤程度有关。结论：运用ＡＮＰ、ＢＮＰ或ＴＲＨ可以对抗ＡＣＩ患者ＡＤＨ分泌增加所引起的机体水钠潴留；低钠血症多集中出现在重伤或特重伤病员中，与下丘脑垂体功能受损致ＥＤＬＳ、ＡＤＨ分泌增加相关。
Aim: This study aims at better understanding of mechanism of imbalance of water salt in patients with acute craniocerebral injury (ACI) and exploration of potential treatment for the dysfunction. Methods: This study was based on 68 patients with ACI. The changes of atrial natriuretic peptide (ANP), brain natriuretic peptide (BNP), endogenous digitalis like substance (EDLS), antidiuretic hormone (ADH) and serum Na +, urine Na +, plasma osmolality, urine osmolality were observed. The TRH provocative test was observed in GCS≤8 patients. Results: In the ACI patients, the blood ANP and BNP concentrations were statistically lower than those of the controls. and the changes of ANP and BNP had no correlation with the GCS. The concentrations of EDLS and ADH were statistically higher than those of the controls, and there was a correlation between the EDLS, ADH levels and GCS. Conclusion: Hyponatremia was found mostly in severe or fatal patients and might be related to abnormal secretion of EDLS and ADH as the result of the hypothalamic hypophysial system injury. ANP, BNP and TRH might inhibit water saline preference by antagonising the increase of ADH.
出处
《中华创伤杂志》
CAS
CSCD
北大核心
1996年第2期96-98,共3页
Chinese Journal of Trauma
关键词
颅脑外伤
急性
利钠因子
抗利尿激素
Craniocerebral injury, acute Natriuretic factor Antidiuretic hormone Thyrotropin releasing hormone Hyponatremia
