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[脑脊液及血液中钾、钠水平对昏迷患者的预后价值。55例患者的研究]

[Prognostic value of potassium and sodium levels in cerebrospinal fluid and blood in patients with coma. Study of 55 cases].

作者信息

Gagliardi R J

出版信息

Arq Neuropsiquiatr. 1982 Sep;40(3):230-8. doi: 10.1590/s0004-282x1982000300003.

Abstract

This is a prospective study, with 55 patients in coma, in which wasn't chosen sex, age, intensity of coma or etiology. It was measured the concentration of the potassium and the sodium in cerebrospinal fluid, (CSF) and in the serum, to find an auxiliary way to value the prognostic. It is known that the potassium in the CSF is extremely stable, and it maintains the tax without alterations, even when the potassium in CSF is rapid and intensity raised after death. Experimental studies show the potassium raised in CSF in serious damaged brain. Our results show, in patients who recovered consciousness, normal values (means 2,61 mEq/1) of potassium in CSF. The mean of values of potassium in CSF in the group of patients who had bad evolution (they died) show index estatisticaly up of normal values (2,97 mEq/1) and this shows a serious damaged brain and/or irreversible, able to affect the stability of CSF potassium. These index are present in some kind of coma or etiology, showing that raised potassium in CSF, indicates bad prognostic, in some kind of coma. With the sodium, the results show that this ion doesn't serve to this finality, because its concentrations isn't stable in CSF, and change with the blood alterations of natremia.

摘要

这是一项前瞻性研究,纳入了55例昏迷患者,未选择性别、年龄、昏迷程度或病因。测量了脑脊液(CSF)和血清中的钾和钠浓度,以寻找一种辅助评估预后的方法。已知脑脊液中的钾极其稳定,即使死后脑脊液中的钾迅速且强烈升高,其水平也保持不变。实验研究表明,严重脑损伤时脑脊液中的钾会升高。我们的结果显示,恢复意识的患者脑脊液中的钾值正常(平均2.61 mEq/1)。病情恶化(死亡)的患者组脑脊液中钾值的平均值在统计学上高于正常值(2.97 mEq/1),这表明脑损伤严重和/或不可逆,会影响脑脊液钾的稳定性。这些指标在某些类型的昏迷或病因中存在,表明脑脊液中钾升高在某些类型的昏迷中提示预后不良。对于钠,结果表明该离子不适合用于此目的,因为其在脑脊液中的浓度不稳定,会随血钠血症的血液变化而改变。

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