新生儿缺氧缺血性脑病低钠血症与血浆脑利钠肽相关性研究

目的探讨新生儿缺氧缺血性脑病(HIE)低钠血症与血浆脑利钠肽(BNP)相关性；HIE病理过程中的BNP及低钠血症生理和病理作用机制。方法枣阳市第一人民医院于2002年10月至2004年10月，动态观察22例低钠血症HIE患儿3日龄、7日龄和2周时血浆BNP和血钠水平，并进行相关性分析。同时与血钠正常的52例HIE患儿及血钠正常非HIE患儿(对照组)进行比较。结果3日龄HIE患儿BNP显著高于对照组(P<001)；7日龄时，血钠正常的HIE患儿与对照组之间已无明显统计学差异，而低钠血症HIE组明显高于血钠正常HIE组(P<001)；低钠血症组的三个时间段BNP之间差异均具有显著性(P<001)；低钠血症组各时间段的血钠浓度呈递减，依次比较差异有显著性。低钠血症HIE组与血钠正常HIE组相应时间段行为神经(NBNA)测定比较差异具有显著性(P<001)；低钠血症组的HIE患儿在三个时间段NBNA比较差异具有显著性(P<005)。低钠血症组BNP水平与血钠离子在各时间段具有负相关性。结论BNP参与和导致了HIE低钠血症，并直接和经过低钠介导在HIE病理过程中起重要作用。

Correlation between brain natriuretic peptide in blood plasma and hyponatremia in the newborn with hypoxia ischemic encephalopathy.

AbstractObjectiveTo studying the correlation between brain natriuretic peptide(BNP) in blood plasma and hyponatremia in hypoxia ischemic encephalopathy(HIE) of the newborn and the physiological and pathological mechanism of BNP and hyponatremia in the pathological course of HIE.MethodsObserve BNP in blood plasma and natrium level dynamically in 22 infants with HIE,including the age of 3 days,7days and 2 weeks,and analyse the correlation.In the mean time make a comparison between 52 infants with HIE with normal blood natrium and infants with non HIE with normal blood natrium.ResultsBNP of infants with HIE aged 3 days was remarkably higher than the control group(P<001);in the 7 days aged,there was no obvious difference between the infants with HIE with normal blood natrium and the control group,while the hyponatremia group was still distinctly higher than the normal blood natrium group (P<001).The difference among BNP in the hyponatremia group was distinct in the three periods(P<001).There was a decrease of the blood natrium density in the hyponatremia group at every period.The ordinal comparison difference was distinct.The neonatal behavioral neurological assessment (NBNA) comparison difference in the relative period was remarkable (P<001) at the hyponatremia group and normal blood natrium group.NBNA comparison difference was remarkable (P<001) at the three periods for the infants with HIE in hyponatremia group.BNP level and blood natrium ion in the hyponatremia group had a negative relationship in each period.ConclusionBNP might cause and participate in hyponatremia in infants with HIE,and may play an important role in the pathogenesis of HIE directly or by hyponatremia intraduction.