Cotton M F, Donald P R, Schoeman J F, Van Zyl L E, Aalbers C, Lombard C J
Department of Pediatrics and Child Health, University of Stellenbosch, Republic of South Africa.
Childs Nerv Syst. 1993 Feb;9(1):10-5; discussion 15-6. doi: 10.1007/BF00301927.
Intracranial pressure (ICP) monitored shortly after admission over a period of 1 h in 31 children with tuberculous meningitis (TBM) was significantly higher (median 22.5 mmHg, range 8.4-50.9 mmHg) in 19 children with laboratory evidence of the syndrome of inappropriate antidiuretic hormone secretion (SIADH) than in 12 children without such evidence (median 16.2 mmHg, range 5.8-42.5 mmHg; P = 0.027). Neither plasma nor cerebrospinal fluid arginine vasopressin (AVP) was related to ICP (r = 0.33 and 0.13 respectively). Mean arterial pressure (MAP) was measured in 23 children and a moderate correlation was found with plasma AVP (r = 0.62; P = 0.0019). In TBM, plasma AVP may be secreted as a response to raised ICP in an effort to raise MAP and maintain cerebral perfusion pressure. In this setting excess fluid may be inappropriately retained, leading to hyponatremia and hypo-osmolemia.
31例结核性脑膜炎（TBM）患儿入院后短期内1小时内监测的颅内压（ICP），19例有抗利尿激素分泌异常综合征（SIADH）实验室证据的患儿显著高于（中位数22.5 mmHg，范围8.4 - 50.9 mmHg）12例无此证据的患儿（中位数16.2 mmHg，范围5.8 - 42.5 mmHg；P = 0.027）。血浆和脑脊液精氨酸加压素（AVP）均与ICP无关（分别为r = 0.33和0.13）。对23例患儿测量了平均动脉压（MAP），发现其与血浆AVP有中度相关性（r = 0.62；P = 0.0019）。在TBM中，血浆AVP可能作为对ICP升高的一种反应而分泌，以提高MAP并维持脑灌注压。在这种情况下，过多的液体可能会被不适当潴留，导致低钠血症和低渗血症。
