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目的 :探讨血浆心钠素 (ANP)与抗利尿激素 (ADH)在窒息新生儿合并低钠血症中所起的作用及其临床意义。方法 :应用放射免疫分析法对 4 0例窒息新生儿血浆ANP、ADH水平变化进行动态观察 ,并与 2 0例正常足月儿进行对照 ,同时观察补液量对血清钠变化的影响。结果 :①新生儿窒息急性期血浆ANP、ADH水平明显增高 ,窒息程度越重 ,血浆ANP、ADH水平越高 ,血清钠水平越低 (P <0 0 1)。②限水组生后一周血清钠水平已恢复正常 ,未限水组血清钠明显低于正常。结论 :ANP、ADH可影响窒息新生儿水盐代谢 ,引起以稀释性低钠血症为主的稀释性和失钠性低钠血症。治疗应严格控制液体量 <3 0～ 50ml·kg- 1/d ,适当补钠 ,必要时可用速尿利尿
Objective: To investigate the role and clinical significance of plasma atrial natriuretic peptide (ANP) and antidiuretic hormone (ADH) in neonatal asphyxia with hyponatremia. Methods: Radioimmunoassay was used to observe the plasma levels of ANP and ADH in 40 asphyxiated newborn infants and to compare them with 20 normal term infants. The effects of fluid volume on the changes of serum sodium were also observed. Results: ① The plasma levels of ANP and ADH were significantly increased in neonates with acute asphyxia, the more the degree of asphyxia was, the higher the levels of plasma ANP and ADH were, the lower the level of serum sodium was (P <0.01). ② water restriction group after a week serum sodium levels have returned to normal, not limit water serum sodium was significantly lower than normal. Conclusion: ANP and ADH can affect the metabolism of water and salt in neonates with asphyxia, causing the dilutional and sodium-losing hyponatremia with dilutional hyponatremia. Treatment should be strictly controlled liquid volume <3 0 ~ 50ml · kg-1 / d, appropriate sodium, if necessary, furosemide diuretic