Department of Spinal Surgery, The First Affiliated Hospital of Anhui Medical University, Heifei, China.
Department of Medical Imaging, Bengbu Medical College, Bengbu, China.
Spinal Cord. 2018 Jan;56(1):84-89. doi: 10.1038/sc.2017.103. Epub 2017 Sep 12.
A retrospective study.
The objectives of the study were to investigate the predictors for hyponatraemia in patients with cervical spinal cord injuries (CSCIs) and to define the relationship between magnetic resonance imaging (MRI) scans and hyponatraemia.
The study was carried out at The First Affiliated Hospital of Anhui Medical University.
A total of 292 patients with CSCIs were retrospectively reviewed to determine the predictors of hyponatraemia. Fourteen variables were extracted from the medical records: age, sex, blood pressure (BP), tracheostomy, serum potassium, serum chloride, serum bicarbonate, serum albumin, intravenous fluid intake and urine volume for 24 h, haematocrit, haemoglobin, neurological assessment and four MRI signal patterns. Univariate and multivariate analyses were used to determine the effect of each variable on hyponatraemia.
Eighty-two of the 270 patients (30%) developed hyponatraemia. Univariate analyses indicated that the following variables were significant predictors of hyponatraemia: tracheostomy; the initial American Spinal Injury Association (ASIA) Impairment Scale (AIS) A assessment; and haemorrhage changes on T2-weighted MRI scans, and low BP. Multivariate regression analyses revealed two variables were significant predictors of hyponatraemia: haemorrhage changes on T2-weighted MRI scans and low BP.
Haemorrhage changes on MRI scans were closely associated with the onset of hyponatremia and could provide objective data for forecasting hyponatraemia in CSCI patients. Low BP was also a reasonable predictor of hyponatremia.
回顾性研究。
本研究旨在探讨颈椎脊髓损伤（CSCI）患者低钠血症的预测因素，并定义磁共振成像（MRI）扫描与低钠血症之间的关系。
该研究在安徽医科大学第一附属医院进行。
回顾性分析 292 例 CSCI 患者，确定低钠血症的预测因素。从病历中提取 14 个变量：年龄、性别、血压（BP）、气管切开术、血钾、血氯、血碳酸氢盐、血清白蛋白、24 小时静脉补液量和尿量、红细胞压积、血红蛋白、神经评估和 4 种 MRI 信号模式。采用单因素和多因素分析确定每个变量对低钠血症的影响。
270 例患者中有 82 例（30%）发生低钠血症。单因素分析表明，以下变量是低钠血症的显著预测因素：气管切开术、初始美国脊髓损伤协会（ASIA）损伤量表（AIS）A 评估、T2 加权 MRI 扫描上的出血改变以及低 BP。多因素回归分析显示，有两个变量是低钠血症的显著预测因素：T2 加权 MRI 扫描上的出血改变和低 BP。
MRI 扫描上的出血改变与低钠血症的发生密切相关，可为预测 CSCI 患者低钠血症提供客观数据。低 BP 也是低钠血症的合理预测因素。
