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急性尿毒症时脑电图的变化。甲状旁腺激素和脑电解质的影响。

Changes in the electroencephalogram in acute uremia. Effects of parathyroid hormone and brain electrolytes.

作者信息

Guisado R, Arieff A I, Massry S G, Lazarowitz V, Kerian A

出版信息

J Clin Invest. 1975 Apr;55(4):738-45. doi: 10.1172/JCI107984.

Abstract

Studies were carried out in order to evaluate the effects of changes in brain calcium and the influence of parathyroidectomy and administration of parathyroid extract on the electroencephalogram (EEG) of normal and uremic dogs. Manual analysis of frequency and power distribution of the EEG in uremic dogs revealed a significant increase in both the percentage distribution and the area or power occupied by frequencies below 5 Hz. In addition, high amplitude bursts of delta activity were apparent in the uremic dog. These changes were largely prevented by parathyroidectomy before the induction of uremia, but the administration of parathyroid extract to either normal dogs, or to previously parathyroidectomized uremic dogs, induced EEG changes similar to those noted in uremic animals with intact parathyroid glands. In all groups of animals which showed EEG changes, brain content of calcium was significantly higher than in either normal dogs or previously parathyroidectomized uremic dogs. Changes in arterial pH and bicarbonate, or in the concentrations of Na+, K+, urea, or creatinine in plasma or cerebrospinal fluid were similar in uremic animals with intact parthyroid glands and in previously parathyroidectomized uremia dogs. The results indicate that the EEG changes found in dogs with acute renal failure require the presence of excess parathyroid hormone in blood, and they may be related to the observed changes in brain content of calcium.

摘要

开展了多项研究,以评估脑钙变化的影响,以及甲状旁腺切除术和给予甲状旁腺提取物对正常犬和尿毒症犬脑电图(EEG)的影响。对尿毒症犬脑电图的频率和功率分布进行人工分析发现,低于5Hz频率的分布百分比以及所占面积或功率均显著增加。此外,尿毒症犬中明显出现高振幅的δ活动爆发。在诱发尿毒症之前进行甲状旁腺切除术可在很大程度上预防这些变化,但对正常犬或先前已进行甲状旁腺切除的尿毒症犬给予甲状旁腺提取物,会诱发与甲状旁腺完整的尿毒症动物中所观察到的类似脑电图变化。在所有出现脑电图变化的动物组中,脑钙含量均显著高于正常犬或先前已进行甲状旁腺切除的尿毒症犬。甲状旁腺完整的尿毒症动物与先前已进行甲状旁腺切除的尿毒症犬在动脉pH值和碳酸氢盐、或血浆或脑脊液中Na+、K+、尿素或肌酐浓度方面的变化相似。结果表明,急性肾衰竭犬中发现的脑电图变化需要血液中存在过量的甲状旁腺激素,并且它们可能与所观察到的脑钙含量变化有关。

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