Fukui K, Inamura T, Nakamizo A, Inoha S, Kawamura T, Sayama T, Matsushima T, Fukui M
Department of Neurosurgery, Graduate School of Medical Science, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan.
No To Shinkei. 2000 Nov;52(11):1019-23.
Several authors described elevated natriuretic peptides, atrial natriuretic peptide(ANP) and brain natriuretic peptide (BNP), in patients with subarachnoid hemorrhage(SAH), which were account for inappropriate antidiuretic hormone(SIADH) or cerebral salt wasting syndrome(CSW). Although the secretion of natriuretic peptide depends on the total blood volume, central venous pressure, and cardiac output volume, the volume of fluid intake in patients with SAH had not been taken in consideration in previous report. We here examined the relationship between fluid intake and the natriuretic peptides in two cases without cardiac failure. ANP elevated 2 or 3 days after SAH and remained in normal range for 2 weeks. BNP elevated when the volume of fluid intake was increased, and BNP did not elevate during the periods with lower fluid intake. Several authors proposed the possibility of iatrogenic factor in natriuresis after SAH and these results supported this opinion.
几位作者描述了蛛网膜下腔出血（SAH）患者中利钠肽、心房利钠肽（ANP）和脑利钠肽（BNP）升高的情况，这与抗利尿激素分泌不当综合征（SIADH）或脑性盐耗综合征（CSW）有关。尽管利钠肽的分泌取决于总血容量、中心静脉压和心输出量，但之前的报告并未考虑SAH患者的液体摄入量。我们在此研究了2例无心力衰竭患者的液体摄入量与利钠肽之间的关系。SAH后2或3天ANP升高，并在2周内保持在正常范围内。当液体摄入量增加时BNP升高，而在液体摄入量较低的时期BNP不升高。几位作者提出了SAH后利尿可能存在医源性因素的可能性，这些结果支持了这一观点。
