Frisbie J H
Spinal Cord Injury Service (128), Boston Healthcare Center, West Roxbury, MA, USA.
Spinal Cord. 2007 Aug;45(8):563-8. doi: 10.1038/sj.sc.3101984. Epub 2006 Oct 10.
Case control.
To test the reported correlation of hypotension, polydipsia, and hyponatremia with higher levels of spinal cord injury (SCI).
A Veterans Administration Hospital, USA.
The records of men who were paralyzed owing to trauma at any spinal cord level with motor complete lesions (ASIA A or B) and who received an annual physical and laboratory examination were reviewed for age, duration of paralysis, level of paralysis, blood pressure (BP), serum sodium, and 24 h urinary volume, creatinine, and sodium. Creatinine clearance and fractional excretion of sodium (FcNa) were calculated. Spearman rank-order correlations (r (s)) were carried out.
Patients were aged 25 to 88 years, median 56 years, paralyzed 2-61 years, median 26 years, with levels of paralysis ranging from C2 to L4, median T4, n=111. From lower to higher levels of paralysis FcNa increased (0.4-7.3%), mean BP diminished (132-66 mmHg), urine volume increased (600-5400 ml), and serum sodium was reduced (148-129 mEq/l) - r (s)=0.29, 0.49, -0.22, and 0.23, respectively. Increasing 24 h urinary volumes correlated with lower serum sodium concentrations but higher creatinine clearance, r (s)=-0.28, 0.24. Increasing 24 h urinary sodium improved creatinine clearance, r (s)=0.37. P-values ranged from <0.05 to <0.001.
Higher levels of SCI correlate with reduced sodium conservation, hypotension, polydipsia, and hyponatremia. Greater water intake raises creatinine clearance but lowers serum sodium. Greater salt intake increases creatinine clearance.
病例对照研究。
检验所报道的低血压、烦渴和低钠血症与更高脊髓损伤（SCI）水平之间的相关性。
美国一家退伍军人管理局医院。
回顾因任何脊髓节段创伤导致瘫痪且运动完全性损伤（美国脊髓损伤协会分级A或B级）并接受年度体格检查和实验室检查的男性患者的记录，检查内容包括年龄、瘫痪持续时间、瘫痪节段、血压（BP）、血清钠、24小时尿量、肌酐和钠。计算肌酐清除率和钠分数排泄率（FcNa）。进行Spearman等级相关性分析（r(s)）。
患者年龄25至88岁，中位数56岁，瘫痪2至61年，中位数26年；瘫痪节段从C2至L4，中位数T4；n = 111。随着瘫痪节段从低到高，FcNa升高（0.4 - 7.3%），平均血压降低（132 - 66 mmHg），尿量增加（600 - 5400 ml），血清钠降低（148 - 129 mEq/l），r(s)分别为0.29、0.49、 - 0.22和0.23。24小时尿量增加与较低的血清钠浓度相关，但与较高的肌酐清除率相关，r(s)分别为 - 0.28、0.24。24小时尿钠增加可改善肌酐清除率，r(s) = 0.37。P值范围为<0.05至<0.001。
更高的脊髓损伤水平与钠潴留减少、低血压、烦渴和低钠血症相关。更多的水摄入会提高肌酐清除率但降低血清钠。更多的盐摄入会增加肌酐清除率。
