ANP, ADH In The Role Of The Subsequent Hyponatremia In Intracranial Disorders After Severe Craniocerebral Injury

Objective:To study clinical significance of distinction of central hyponatremia t hrough the change of serum level of antidiurefic hormone and atrial nat riuretic peptide after sever craniocerebral injury.To find out the incidenc e rate of central hyponatremia after severe craniocerebral injury and the relationship of the hyponatremia to plasma ANP and ADH in order to provide better clinical validation and correlative theoretic basis.Method:This thesis chooses randomly 100 patients of craniocerebral injury with blood serum natrium＜135mmo1/1 and GCS＜8;and randomly 30 patients of head injury with normal blood serum natrium as its compa rison monitors their urine natrium in 24 hours;blood serum natriurn,CV P,BOP(blood osmotic pressur);observes their change of every items 3 days before supply natrium and 2days after supplying natrium;or 6 day s after limiting water.ANP and ADH were all measured by radioimmuno assary in 2 h,4 h,8h,12 h,24 h,36 h,48 h,72 and 7,14,21 days.Grouping:SIADH:(n=19),CSWS:(n=32).All date showed by m eans of average plus or minus standard deviations and correlative analy sis was applied to compare one sample with another by SPSS11.0.All results were considered statistically significant at P＜0.05.Result:1 The levels of ANP and ADH of experiment group were preopera tive higher than the comparison(P＜0.05).ANP statistical correlation with hyponatremia was negatively correlated.2 The group of SIADH has 19cases,consisting 28.04%;the group of CSWS has 32cases,consisting 47.56%,other has 18 cases.The le vel of ADH of SIADH was higher than CSWS and comparison(P＜0.05). And in contrast the level of ADP of the CSWS was higher than others (P＜0.05).3 In the group of SIADH,the serum level of antidiuretic hormone i ncreased after attack,and arrived the peak(170±25pg/ml) after 72 hours, then descend.At the same time,the serum level of atrial natriuretic p eptide increased after attack,and arrived the peak(280+15pg/ml) after 3 6 hours,then descend.4 In the group of CSWS,the serum level of antidiuretic hormone i ncreased after attack,and arrived the peak(135±23pg/ml) after 72 hours, then descend.At the same time,the serum level of atrial natriuretic p eptide increased after attack,and arrived the peak(440±35pg/ml) after 4 8 hours,then descend.Conclusion:Though the concentration curve of antidiuretic hormone and atrial n atriuretie peptide,we can distinguish distinguish syndrome of inappropria te antidiuretic hormone secretion from cerebral salt wasting syndrome.T he correct differential diagnosis and seemly treatment are beneficial for decreasing misdiagnosis and patients' prognosis.