临床神经外科杂志2023，Vol.20Issue(6)：646-652,7.DOI:10.3969/j.issn.1672-7770.2023.06.009
颅内动脉瘤破裂后并发低钠血症的类型与动脉瘤位置的关系
Relationship between type of hyponatremia after intracranial aneurysm rupture and location of aneurysm
摘要
Abstract
Objective To explore whether the syndrome of inappropriate antidiuretic hormone secretion(SIADH)and cerebral salt wasting syndrome(CSWS)in aneurysmal subarachnoid hemorrhage(aSAH)complicated with hyponatremia varies depending on the location of ruptured aneurysms.Methods The clinical data of patients with aSAH complicated with hyponatremia admitted to the Department of Neurosurgery,Shengjing Hospital Affiliated to China Medical University from January 2016 to December 2018 were analyzed retrospectively.Based on the etiology of hyponatremia,they were divided into SIADH group(N=120)and CSWS group(N=40),and their clinical characteristics were observed and compared.Single factor analysis and multivariate logistic regression were used to analyze the influencing factors of hyponatremia.Result A total of 160 patients were included in the study,including 120 patients with SIADH(75％)and 40 patients with CSWS(25％);There were 102 cases(64％)of anterior circulation aneurysms and 58 cases(36％)of posterior circulation aneurysms.Univariate analysis confirmed that SIADH was more common in anterior circulation aneurysms than CSW compared to posterior circulation aneurysms(P=0.004).Compared with other sites,the incidence of SIADH in patients with anterior communicating artery aneurysm was higher than that in CSWS(P=0.038).More severe Hunt Hess grading was associated with the development of CSWS(P=0.007).Compared with patients in SIADH group,patients in CSWS group experienced more early hyponatremia(P=0.03).Multiple logistic regression analysis further confirmed that the incidence of SIADH in patients with anterior circulation aneurysms was significantly higher than that in patients with posterior circulation aneurysms(P=0.041).The incidence of CSWS was higher in Hunt Hess grade 3-4 patients(P=0.013).Conclusions SIADH is the leading cause of hyponatremia in aSAH patients and is more common than CSWS.The incidence of SIADH is higher in patients with anterior circulation aneurysms than in patients with posterior circulation aneurysms.关键词
低钠血症/抗利尿激素分泌异常综合征/脑耗盐综合征/动脉瘤部位Key words
Hyponatremia/SIADH/CSWS/aneurysm location分类
医药卫生引用本文复制引用
杜赛,刘岳,傅楚华,胡少荣,关俊宏..颅内动脉瘤破裂后并发低钠血症的类型与动脉瘤位置的关系[J].临床神经外科杂志,2023,20(6):646-652,7.基金项目
湖北省教育厅科学研究计划资助项目(D202222103) （D202222103）
