学术论文

      热性惊厥患儿血清钠、尿钠水平变化及临床意义

      Changes of serum sodium and urine sodium of children with febrile seizures and its clinical significance

      摘要:
      目的:分析不同发作类型、不同抽搐持续时间、不同抽搐时体温的热性惊厥儿尿钠及血清钠的变化,探讨其临床意义。方法选择热性惊厥患儿50例、发热无抽搐患儿50例、健康查体并排除神经源性疾病的健康儿童20例。测定三组儿童尿钠、尿肌酐的浓度及血清钠水平。结果热性惊厥组尿钠/尿肌酐为(25.07±6.51),与发热无抽搐组的(20.43±5.48)、健康儿童组的(14.88±5.11)差异有统计学意义(F =33.519,P <0.05),热性惊厥组血钠[(133.50±3.14)mmol/L]与发热无抽搐组[(137.60±2.59)mmol/L]、健康儿童组[(138.90±2.24)mmol/L]差异有统计学意义(F =39.220,P <0.05),热性惊厥组血钠明显低于发热无抽搐组及健康儿童组(t =0.558、0.738,P <0.05);热性惊厥组尿钠/尿肌酐与血钠呈负相关(r =-0.517,P <0.05)。结论儿童发生热性惊厥时,尿钠排出明显增多,血钠降低。血钠、尿钠改变与惊厥发生时体温、惊厥持续时间及惊厥类型无明显相关性。热性惊厥儿童应及时监测血钠、尿钠水平,根据患儿血钠、尿钠水平变化,早期适当补充含钠液体,使血钠保持正常水平,减少惊厥的复发。
      Abstract:
      Objective To analyze the changes of the urine sodium and serum sodium in different types and different duration and different temperature in children with febrile seizures,to explore its clinical significance. Methods The children with febrile seizures(n =50)were selected as the group Ⅰ,and the children with fever but without seizure(n =50)were selected as the group Ⅱ,both of them were from pediatric ward.The control group(n =20)without fever or seizure was from Children's Health Section.All the children were checked serum sodium level and urine sodium and urine creatinine level.Results The sodium/creatinine ratio in the groupⅠ[(25.07 ±6.517)] was significantly higher than that in the group Ⅱ[(20.43 ±5.48)]and group Ⅲ[(14.88 ±5.11)](F =33.519, P <0.05),but there was no significant difference of the sodium/creatinine ratio in different ages and different types of the group Ⅰ,and there was negative relevance between the serum sodium and the sodium/creatinine ratio in the groupⅠ(r =-0.517,P <0.05).The mean serum sodium level in the groupⅠ[(133.50 ±3.14)mmol/L]was signifi-cantly lower than that in the group Ⅱ[(137.60 ±2.59)mmol/L]and group Ⅲ[(138.90 ±2.24)mmol/L](F =39.220,P <0.05),but there were no significant differences of the serum sodium in different types and different dura-tion and different temperature of seizure in the group Ⅰ.Conclusion The study shows that serum sodium is lower and the urine sodium is higher in children with febrile seizures,the changes of the urine sodium and serum sodium are not related to the types.The children with febrile seizures should be timely monitoring of serum sodium,urine sodium levels,and according to changes in the level of serum sodium,urine sodium,early appropriate supplement containing sodium liquid and maintaining the blood sodium to normal levels can reduce the recurrence of seizure.
      作者: 戴汝均 [1] 林冬云 [1] 罗向阳 [2]
      Author: Dai Rujun [1] Lin Dongyun [1] Luo Xiangyang [2]
      作者单位: 清远市人民医院儿内科, 广东省清远,511500 中山大学孙逸仙纪念医院儿内科, 广东省广州,540105
      刊 名: 中国基层医药 ISTIC
      年,卷(期): 2017, 24(6)
      在线出版日期: 2017年3月29日