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早产和足月新生儿的钠排泄与钠摄入量及醛固酮排泄的关系

Sodium excretion in relation to sodium intake and aldosterone excretion in newborn pre-term and full-term infants.

作者信息

Aperia A, Broberger O, Herin P, Zetterström R

出版信息

Acta Paediatr Scand. 1979 Nov;68(6):813-7. doi: 10.1111/j.1651-2227.1979.tb08217.x.

Abstract

The importance of aldosterone for the control of salt balance has been examined in pre-term infants (gestational age 28--34 weeks) and in full-term infants. The post-natal age has varied from 2--21 days. Eight-hour urinary specimens have been analysed with regard to sodium, potassium and aldosterone. The daily sodium intake has been recorded following determination of milk intake and analyses of sodium in breast milk. Due to variations of sodium content of breast milk, the daily sodium intake in pre-term infants was lower than in full-term infants during the first 10 days of life. The sodium excretion was significantly higher in pre-term infants than in full-term infants during the first six days of life. During the first week of life the sodium balance is negative in pre-term infants and positive in full-term infants. Aldosterone excretion is high during the first week of life and increases further from the 2nd to the 3rd week of life in both pre-term and full-term infants. The correlation between aldosterone excretion and urinary potassium/sodium quotient is 0.87 in full-term infants, 0.57 in pre-term infants aged 13--20 days and does not exist in pre-term infants aged 2--10 days. It is suggested that the high sodium excretion in newborn pre-term infants can in part be explained by an unresponsiveness to aldosterone at this developmental stage.

摘要

已对早产儿(胎龄28 - 34周)和足月儿体内醛固酮对盐平衡控制的重要性进行了研究。出生后年龄为2至21天。对8小时的尿液样本进行了钠、钾和醛固酮分析。在测定牛奶摄入量并分析母乳中的钠之后,记录了每日钠摄入量。由于母乳中钠含量的变化,早产儿出生后头10天的每日钠摄入量低于足月儿。出生后头6天,早产儿的钠排泄量显著高于足月儿。在出生后的第一周,早产儿的钠平衡为负,足月儿的钠平衡为正。在出生后的第一周,醛固酮排泄量很高,并且在早产儿和足月儿中,从出生后第2周持续到第3周醛固酮排泄量进一步增加。足月儿中醛固酮排泄量与尿钾/钠商的相关性为0.87,13至20日龄的早产儿中该相关性为0.57,而在2至10日龄的早产儿中不存在这种相关性。有人提出,新生儿早产儿钠排泄量高的部分原因可能是在此发育阶段对醛固酮无反应。

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