【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(r2=-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(r2=-0.693和r3=-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。更多还原

【Abstract】 ObjectiveTo explore the relationships among atrial natriuretic peptide (ANP) and cerebral vasospasm (CVS) following subarachnoid hemorrhage (SAH) and hyponatremia.MethodsPlasma 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. Correlation analysis was carried out among plasma ANP, blood sodium level and blood flow rate of intracal major arterial.Results28 patients had CVS. Plasma ANP levels in CVS patients significantly elevated compared with non-CVS and control subjects ( P<0.05). 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 ( r2=-0.778, r3=-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 ( r3=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 ( r2=-0.693, r3=-0.653 , both P<0.05) in SAH patients.ConclusionANP might cause hyponatremia following SAH and play an important role in pathogenesis of earlier period CVS.更多还原