Kojima T, Hirata Y, Umeda Y, Sato Y, Fukuda Y, Matsuzaki S, Iwase S, Kobayashi Y
Department of Pediatrics, Kansai University, Japan.
Acta Paediatr Scand. 1989 Sep;78(5):793-6. doi: 10.1111/j.1651-2227.1989.tb11149.x.
A fullterm infant had fetal distress and stained amnion. He underwent an exchange blood transfusion at 12 hours after birth because of hyperbilirubinemia. He developed oliguria combined with high urine osmolality during the first 27 hours of life despite normal creatinine clearance. The diagnosis of the syndrome of inappropriate antidiuretic hormone secretion (SIADH) was made on the basis of high urine osmolality, low plasma osmolality and elevated plasma arginine vasopressin (AVP) concentration. We determined the plasma atrial natriuretic peptide (ANP) concentration for the first 4 days of life. After 27 hours after birth, urine volume increased while plasma AVP concentration remained high. On the other hand, plasma ANP concentration gradually increased after 27 hours of life. We speculate that ANP may play an important role in producing the spontaneous diuresis in the newborn infant with SIADH.
一名足月儿出现胎儿窘迫和羊水粪染。由于高胆红素血症，他在出生后12小时接受了换血治疗。尽管肌酐清除率正常，但在出生后的头27小时内，他出现了少尿并伴有高尿渗透压。基于高尿渗透压、低血浆渗透压和血浆精氨酸加压素（AVP）浓度升高，做出了抗利尿激素分泌不当综合征（SIADH）的诊断。我们测定了该患儿出生后头4天的血浆心钠素（ANP）浓度。出生后27小时后，尿量增加，而血浆AVP浓度仍保持在较高水平。另一方面，出生27小时后血浆ANP浓度逐渐升高。我们推测，ANP可能在患有SIADH的新生儿产生自发性利尿过程中发挥重要作用。
