摘要
目的:评估重度颅脑损伤患者不同时期的血钠、血钾、血浆皮质醇、醛固酮水平的变化,及其在伤情判断与预后中的作用。方法:前瞻性选择重度颅脑损伤患者30例,正常对照组20例,重度颅脑损伤患者根据GCS评分又分为GCS3～5分与GCS6～8分两个亚组,或根据患者是否死亡分为死亡和存活两个亚组,测定不同时期血钠、血钾、血浆皮质醇、醛固酮浓度。结果:GCS3～5分与GCS6～8分组血浆皮质醇、醛固酮的浓度入院后第1天均显著增高,与对照组比较差异有显著性(P<0.01),而GCS3～5分组血浆皮质醇、醛固酮的浓度高于GCS6～8分组(P<0.05)。死亡组和存活组第1天血浆皮质醇、醛固酮的浓度均显著高于对照组(P<0.01),入院第7天死亡组血浆皮质醇、血钾、血钠水平显著高于存活组(P<0.05)。结论:血浆皮质醇、醛固酮水平与病情和预后密切相关,经治疗后出现血钠、血钾的升高提示预后不良,可作为判断病情轻重和预后的一项重要指标。
Objective To investigate the clinical significance of the changes of serum natrium and potassium and plasma cortisel and aldosterone in patients with severe cranial trauma. Methods 30 patients with severe cranial trauma were divided into GCS 3 -5 and 6 - 8 group based on their GCS score or death and survival group owing to their survival status. Their serum natrium, potassium, plasma cortisol and aldosterone were detected in different periods. Blood samples from 20 healthy individuals were used as control. Results Plasma cortisol and aldosterone in the GCS 3 - 5, GCS 6 - 8, dead and survival group were significantly increased than those in the control group on the first day of hospitalization （ P 〈 0. 01 ）. Plasma cortisol and aldosterone in the GCS 3 - 5 group were much higher than those in the GCS 6 - 8 group （ P 〈 0. 05） . Serum natrium, potassium and plasma cortisol in the dead group were markedly higher than those in the survival group on the seventh day of hospitalization （ P 〈 0. 05）. Conclusions The levels of plasma cortisel and aldosterone are closely related with the severity and prognosis of cranial trauma. The elevated levels of serum natrium and potassium after treatment indicate poor prognosis.
出处
《实用医学杂志》
CAS
2006年第15期1729-1731,共3页
The Journal of Practical Medicine
基金
浙江省温州市卫生局基金资助项目(编号:Y2004A099)
关键词
颅脑损伤
血钠
血钾
皮质醇
醛固酮
Craniooerebral trauma Serum natrium Serum potassium Plasma cortisol Plasma aldosterone
