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目的探讨脑出血患者低钠血症的临床特点、发病机理及其对预后的影响。方法对86例急性脑出血患者的血清钠进行监测,将发病后24h内、24～72h、3～7d及1周后的低钠血症发生率进行对比,并观察与出血量的关系及对预后的影响。结果急性脑出血患者并发低钠血症比例较高,本组达37.2%。其中在3d内,3～7d及1周后的发生率分别为11.6%、16.3%及10.5%,经统计学处理其结果差异无统计学意义(P>0.05),低钠血症发生率与出血量有一定关系(P<0.05),同时也增加患者病死率(P<0.05)。结论急性期脑出血患者出现低钠血症与脑出血本身病理改变有关,其机理复杂,在抗利尿激素分泌异常综合征(SIADH)、脑耗盐综合征(CSWS)和皮质醇分泌失衡综合征三种主流学说中并发抗利尿激素分泌异常综合征(SIADH)机率相对较低。
Objective To investigate the clinical features, pathogenesis and prognosis of hyponatremia in patients with intracerebral hemorrhage. Methods Serum sodium in 86 patients with acute cerebral hemorrhage was monitored. The incidence of hyponatremia was observed within 24h, 24 ~ 72h, 3 ~ 7d and 1 week after onset, and the relationship with the amount of bleeding was analyzed. The impact of prognosis. Results Acute cerebral hemorrhage in patients with a higher proportion of hyponatremia, the group reached 37.2%. Among them, the incidence rates within 3 days, 3 to 7 days and 1 week were 11.6%, 16.3% and 10.5%, respectively. There was no significant difference in the results after statistical analysis (P> 0.05). The incidence of hyponatremia was The amount of bleeding had a certain relationship (P <0.05), but also increased the mortality of patients (P <0.05). Conclusions The occurrence of hyponatremia in patients with acute cerebral hemorrhage is related to the pathological changes of cerebral hemorrhage. The mechanism is complicated. In patients with SIADH, CSWS and Cortisol secretion imbalance syndrome The three mainstream theories of concurrent syndrome of anti-diuretic hormone secretion (SIADH) the probability is relatively low.