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神经外科术后中枢性尿崩症ADH变化曲线及其临床意义

张金男, 高宇飞*, 赵丛海, 王立坤,赵 勇#   

  1. 吉林大学中日联谊医院神经外科, 吉林 长春 130033
  • 收稿日期:2006-01-08 修回日期:1900-01-01 出版日期:2006-11-28 发布日期:2006-11-28
  • 通讯作者: 高宇飞

Clinical significance and change curve of ADH in central diabetes insipidus after neurosurgical operation

ZHANG Jin-nan, GAO Yu-fei*, ZHAO Cong-hai , WANG Li-kun, ZHAO Yong#   

  1. Department of Neurosurgery, China-Japan Union Hospital,Jilin University, Changchun 130033, China
  • Received:2006-01-08 Revised:1900-01-01 Online:2006-11-28 Published:2006-11-28
  • Contact: GAO Yu-fei

摘要: 目的:探讨神经外科术后并发中枢性尿崩症时血清抗利尿激素(ADH)变化曲线对判断不同类型中枢性尿崩症的临床意义。方法:动态观察神经外科手术后出现中枢性尿崩患者158例,采用放射免疫法测定患者术前及术后2周内不同时间点血清ADH浓度,绘制短 暂性、持续性及三相性尿崩症AHD变化曲线。结果:短暂性和三相性尿崩症术后血清ADH立即下降,于术后第2天达最低值,分别为术前血清ADH浓度的41.7%和63.6%,与术前比较差异有显著性(P<0.05)。短暂性尿崩症于术后第10天恢复术前水平,而三相性尿崩症在术后第7天血清浓度达高峰,超过术前水平,后逐渐下降。持续性尿崩症患者术后 血清ADH于术后1 d后下降,于术后第7天 最低值,为术前血清ADH水平的33.3%,后略有波动,但在2周内一直低于术前ADH水平(P<0.05)。结论: 通过对血清ADH变化曲线的分析,可以区分不同类型的中枢性尿崩症,进行有针对性的治疗,改善患者预后。

关键词: 神经性, 神经外科, 激素

Abstract: Objective To study the change curve of ADH in central diabetes insipidus after neurosurgical operation, and analyse the clinical significance of diffe rentiating the types of central diabetes insipidus through the change curve. Methods The serum level of ADH was observed in 158 central diabetes insipidus patients undergone neurosurgical operation. The change curve of ADH in different types of central diabetes insipidus were painted, including transient, continuous and triphasic diabetes insipidus. Results The serum concentrations of ADH in transient and triphasic diabetes insipidus decreased after operation, and arrived the low point (41.7% and 63.6% of the preoperative serum concentration of ADH) after 2 d. The serum concentration of ADH in transient diabetes insipidus recovered to the preoperative level after 10 d. The serum concentration of ADH in triphasic diabetes insipidus arrived the peak after 7 d, then descended. The serum concentration of ADH in continuous diabetes insipidus fell in postoperative 1 d, and arrived the low point (33.3% of the preoperative serum level of ADH) after 7 d. The serum concentration of ADH in continuous diabetes insipidus postoperative 2 weeks was lower than preoperation. Conclusion Though the concentration change curve of ADH, the transient diabetes insipidus can be distinguished from continuous and triphasic diabetes insipidus. The correct differential diagnosis and seemly treatment are beneficial for patients’ prognosis.

Key words: neurogenic, neurosurgery, hormone

中图分类号: 

  • R446.11