早产儿出生后第一周的低钠血症。第一部分。精氨酸加压素分泌
Hyponatraemia in the first week of life in preterm infants. Part I. Arginine vasopressin secretion.
作者信息
Rees L, Brook C G, Shaw J C, Forsling M L
出版信息
Arch Dis Child. 1984 May;59(5):414-22. doi: 10.1136/adc.59.5.414.
Abstract
Continuous sequential urinary arginine vasopressin measurements in 14 preterm, ventilated infants suggest that both osmoreceptor and volume receptor systems are able to stimulate the prolonged secretion of arginine vasopressin from 26 weeks' gestation. The kidney is able to respond to arginine vasopressin stimulation from the first day of life and from 26 weeks' gestation. A maximum urine osmolality not exceeding 550 mOsm/kg was reached which varied with hydration of the infant. Excretion of arginine vasopressin and urine osmolality increased during deterioration of respiratory illness, mask ventilation, bilateral pneumothoraces, and severe intraventricular haemorrhage. The data show that inappropriate arginine vasopressin secretion is common during illness in the first week of life in preterm infants and that strict attention must be paid to water balance during this time.
摘要
对14名早产且使用呼吸机的婴儿进行连续序贯尿精氨酸加压素测量，结果表明，从妊娠26周起，渗透压感受器和容量感受器系统均能够刺激精氨酸加压素的持续分泌。从出生第一天起以及妊娠26周起，肾脏就能对精氨酸加压素刺激产生反应。达到的最大尿渗透压不超过550 mOsm/kg，且随婴儿的水合状态而变化。在呼吸疾病恶化、面罩通气、双侧气胸和严重脑室内出血期间，精氨酸加压素排泄和尿渗透压增加。数据显示，出生后第一周患病期间，早产婴儿精氨酸加压素分泌不当很常见，在此期间必须严格关注水平衡。
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