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目的 探讨轻、中、重度缺氧缺血性脑病 (HIE)新生儿血电解质和渗透压等的变化及其相关性。方法 分析比较 12 0例不同程度的HIE新生儿和 32例正常新生儿的血清钠、钾、氯、游离钙及渗透压。结果 轻、中和重度HIE儿的血清钠分别为 (130 .2± 6 .0 )mmol/L ;(12 6 .3± 9.1)mmol/L ;(12 1.2± 12 .2 )mmol/L ;游离钙分别为 (1.0± 0 .2 )mmol/L ;(0 .9± 0 .2 )mmol/L ;(0 .8± 0 .2 )mmol/L和渗透压分别为 (2 5 6 .7± 11.2 )mOsm/L ;(2 48.7± 2 1.3)mOsm/L ;(2 41.1± 2 2 .2 )mOsm/L均低于正常儿 (136 .1± 1.1)mmol/L ;(1.2± 0 .1)mmol/L ;(2 6 2 .6± 8.8)mOsm/L ,而血清钾水平高于正常儿。轻度HIE患儿的血清氯水平与正常儿无差异 ,中和重度HIE儿的血清氯水平则低于正常儿 ;中度与重度HIE儿的血清钠、游离钙、氯和渗透压无显著差异 ,但均明显低于轻度HIE儿。轻、中和重度HIE儿的血清钾水平无明显差异 ;死亡的HIE儿血清钠和游离钙低且难以恢复 ,血清渗透压间隙 >10mOsm/L。结论 HIE儿可出现低钠、低钙、高钾和低渗透压血症 ;这些病理状态与预后有关。
Objective To investigate the changes of blood electrolytes and osmotic pressure in neonates with mild, moderate and severe hypoxic-ischemic encephalopathy (HIE) and their correlation. Methods The serum sodium, potassium, chloride, free calcium and osmotic pressure of 120 HIE neonates and 32 normal neonates were analyzed and compared. Results Serum sodium in mild, moderate and severe HIE infants was (130.2 ± 6.0) mmol / L, (12.6 ± 3.1) mmol / L, (12.1 ± 12.2 mmol / L) The free calcium values were (1.0 ± 0.2) mmol / L, (0.9 ± 0.2 mmol / L), (0.8 ± 0.2 mmol / L) (12 ± 11.2) mOsm / L; (41.1 ± 22.2) mOsm / L were lower than that of normal children (136.1 ± 1.1) mmol / L; 0. 1) mmol / L; (2 6 2 .6 ± 8.8) mOsm / L, while serum potassium levels were higher than those of normal children. The level of serum chlorine in mild HIE children was similar to that in normal children, and the level of serum chlorine in children with moderate and severe HIE was lower than that in normal children. There was no significant difference in serum sodium, free calcium, chloride and osmotic pressure in children with mild and severe HIE , But were significantly lower than mild HIE children. There was no significant difference in serum potassium levels between mild, moderate and severe HIE infants. Serum sodium and free calcium in the deceased HIE children were low and difficult to recover with a serum osmolality gap> 10mOsm / L. Conclusion HIE infants may have hyponatremia, hypocalcemia, hyperkalemia and hyponatremia; these pathological states are related to the prognosis.