热性惊厥儿童血清脑利钠肽与钠离子水平的临床研究

摘要

Objective To investigate the pathogenesis and clinical significance of BNP and sodium ion in children with febrile convulsion. Methods Forty-eight children with febrile convulsion were enrolled in this study,Including 20 case of complex febrile convulsion(CFC group) ,28 case of simple febrile convulsion(SFC group),20 case of upper respiratory tract infection ( URI group) and 15 health children as the control group were enrolled in this study. the serum levels of BNP were determined by radioimmunoassay, the serum levels of Na + was measured by Full Automatic biochemical analyzer. The statistical analysis was used to compare the difference of each group. Results The serum BNP and NA + levels:BNP level of CFC group was higher than the SFC group,URI group and control group (P<0. 05),and NA + level of CFC group was lower than the other three groups (P<0. 05). There was no statistical difference among the other three groups (P>0. 05). BNP has the negative correlation with NA +(r= -0. 54,P<0. 01). Conclusion Fever convulsion can increase the secretion of BNP, high levels of BNP adjust the wa-ter-electrolyte metabolism,decrease the sodium ion level. Therefore,BNP combining with hyponatremias could induce the onset of convulsion and brain injured. BNP and sodium ion may play an important position in the onset of of febrile convulsion.%目的：探讨脑利钠肽( BNP)和钠离子( Na +)在儿童热性惊厥发病中的作用机制及临床意义。方法选择符合热性惊厥诊断标准的病例48例,其中复杂型热性惊厥组(CFC)20例,单纯型热性惊厥组(SFC)28例,上呼吸道感染组(URI)20例,对照组15例。测定血清BNP水平、Na +水平。各组检测指标通过统计分析比较其差异及相关关系。结果血清BNP和Na离子水平：CFC组BNP水平高于SFC组、URI组和对照组；CFC组Na +水平低于其他组,差异具有显著性(P<0．05)。其他各组之间两两比较差异无显著性(P>0．05)。 BNP与Na +之间具有负相关关系(相关系数 r=-0．54,P<0．01)。结论热性惊厥刺激BNP的分泌,高水平BNP抑制醛固酮系统,使血钠水平下降,降低惊厥阈值。从而发生热性惊厥和惊厥性脑损伤的发生。因此,测定热性惊厥患儿血清中的BNP和Na +水平对热性惊厥的发病机制、分型及预后判断可能具有重要的临床价值。