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目的探讨窒息后新生儿血清钠水平与新生儿脑损害的关系。方法存在轻-重度窒息及宫内缺氧史的283例新生儿,通过临床表现及CT确诊为新生儿缺氧缺血性脑病(H IE)。于入院24h内测其血清钠浓度。结果重度窒息组与轻度窒息组的血清钠浓度分别为(124±7)mmol/L、(134±6)mmol/L,t=4.89,P<0.05。轻度窒息124例,其中发生低钠血症为18例;重度窒息为8例,发生低钠血症为20例,χ2=4.89,P<0.05。发生低钠血症与窒息程度呈正相关性。早产儿组与足月儿组血清钠水平分别为(129±4)mmol/L,(130±7)mmol/L,t=2.294,P<0.05。轻、中、重度H IE三组患儿平均血清钠浓度为(134±4)mmol/L、(131±7)mmol/L、(123±5)mmol/L,中度与轻度H IE之间比较t=7.57,P<0.05;重度与中度H IE之间比较t=8.07,P<0.05。结论重度窒息既可以导致H IE,又可以引起低钠血症,而严重的低钠血症,又能加重缺氧缺血性脑损伤的程度;所以测定血清钠水平对指导治疗H IE及评估预后具有重要的临床意义。
Objective To investigate the relationship between neonatal serum sodium level and neonatal brain damage after asphyxia. Methods A total of 283 newborns with mild to severe asphyxia and intrauterine hypoxia were diagnosed as neonatal hypoxic-ischemic encephalopathy (H IE) by clinical manifestations and CT. Serum sodium concentration was measured 24h after admission. Results Serum sodium concentrations in severe asphyxia group and mild asphyxia group were (124 ± 7) mmol / L and (134 ± 6) mmol / L, respectively, t = 4.89, P <0.05. Mild asphyxia in 124 cases, of which 18 cases of hyponatremia; severe asphyxia in 8 cases, hyponatremia occurred in 20 cases, χ2 = 4.89, P <0.05. Hyponatremia and asphyxia were positively correlated. Serum sodium levels were (129 ± 4) mmol / L, (130 ± 7) mmol / L, t = 2.294, P <0.05 for preterm and full-term infants respectively. The mean serum sodium concentrations in the mild, moderate and severe H IE groups were (134 ± 4) mmol / L, (131 ± 7) mmol / L, (123 ± 5) mmol / L and moderate and mild H IE T = 7.57, P <0.05; t = 8.07 between severe and moderate H IE, P <0.05. Conclusions Severe asphyxia can lead to H IE as well as hyponatremia, and severe hyponatremia, which can aggravate the degree of hypoxic-ischemic brain damage. Therefore, the determination of serum sodium level may play an important role in guiding the treatment of H IE and evaluating Prognosis has important clinical significance.