A SALT WASTING SYNDROME IN INFANCY
A SALT WASTING SYNDROME IN INFANCY
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DOI：
10.1136/adc.33.169.252
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发表时间：
1958-01-01
影响因子：
5.2
通讯作者：
PERRY, JW
中科院分区：
文献类型：
--
作者：
CHEEK, DB;PERRY, JW
方法采用直接阅读火焰光度计（Domingo和Klyne，1949）或直接阅读EEL火焰光度计测定血清、汗液和尿液中钠和钾的浓度。氯化物测定、血清pH值、二氧化碳含量、总体内水分、总体内氯化物均采用先前通信（Cheek，1957）中列出的方法进行测量。为了测定总氯化物，测量溴化物的分布体积，并使用如前所述的微量扩散法（Cheek和West，1955）。这里使用Obrink（1955）的扩散单元（从Rudolf Grave Company，斯德哥尔摩，瑞典获得）。这些装置减少了对固定剂和随后对装置的长时间洗涤的需要，并提高了方法的准确度。血清溴化物重复测定之间的变异小于1%。在从溴化物空间计算细胞外体积指数之前，从总注射量中扣除10%的注射溴化物，以允许8%的注射溴化物进入红细胞，并考虑到溴化物的分布体积比氯化物空间大1 - 2%的事实。这种修正以前已经应用过（奇克，1954年）。最近的工作表明，在大鼠体内，几乎所有的细胞内氯都在红细胞中;因此，在人体中校正的Cl或Br空间可能是真正的细胞外体积的一个很好的近似值。在类似于所述方法的药理学刺激后收集汗液（毛尔和West，1956）。通过公认的程序（医学研究理事会临床内分泌委员会，1951; Reddy，1954）测定尿17-酮类固醇排泄和皮质类固醇排泄。为了评估尿素清除率，根据Landis，Elsom，Bott和Shiels（1935）描述的技术收集24小时内的尿液。病例报告FC，一个3个月大的男婴，是父母健康的第一个孩子。这位母亲在怀孕的最后两个月因体重过度增加、高血压和蛋白尿而住进了妇产医院。引产后，婴儿早产两周，重51磅。分娩并不困难，分娩也很顺利。婴儿母乳喂养两个半月，但未能获得满意的结果。暂时尝试了奶粉混合物，但在3个月大时，由于喂养不良、体重增加不满意和紫绀发作，他被送往皇家儿童医院。紫绀发作在前一个月就已发现，与进食无关。第252章没有陪伴
Methods Sodium and potassium concentrations for serum, sweat andurine were determined on a direct reading flame photometer (Domingo and Klyne, 1949), or by a direct reading EEL flame photometer. Chloride determinations, serum pH, carbon dioxide content, total body water, total body chloride, were all measured by methods set out in a previous communication (Cheek, 1957). To determine total chloride the volume of distribution of bromide was measured and a micro diffusion method was used as described previously (Cheek and West, 1955). Here the diffusion units of Obrink (1955) were used (obtained from Rudolf Grave Company, Stockholm, Sweden). These units obviate the need for fixative and for subsequent prolonged washings of the units and increase the accuracy of the method. The variation between duplicate determinations of serum bromide was less than 1%. Before the calculation of the extracellular volume index from the bromide space, 10% of the injected bromide was deducted from the total injected, to allow for the entrance of 8% of injected bromide into the red blood cells and for the fact that the volume of distribution of bromide is 1-2% greater than the chloride space. This correction has been applied previously (Cheek, 1954). Recent work indicates that in the rat almost all the intracellular chloride of the body is in red cells; hence it may be that the corrected Cl or Br space in man is a good approximation to true extracellularvolume. Sweat was collected following a pharmacological stimulus similar to a method described (Mauer and West, 1956). Urinary 17-ketosteroid excretion, and corticosteroid excretion were assayed by accepted procedures (Medical Research Council Committee on Clinical Endocrinology, 1951; Reddy, 1954). To assess urea clearance, urinewas collected over a 24-hour period accordingto the technique described by Landis, Elsom, Bott and Shiels (1935).Case Report FC, a male infant, aged 3 months, was the first-born of parents who had been previously in good health. The mother was admitted to the matemity hospital during the last two months of pregnancybecause of an excessive gain in weight, hypertension and albuminuria. Labour was induced and the baby was born two weeks prematurely, weighing 5i lb. Labour was not difficult and delivery was uneventful. The infant was breast fed for two and a half months but failed to gainsatisfactorily. A dried milk mixture was triedtemporarily but at the age of 3 months he was brought to the Royal Children's Hospital because of poor feeding, unsatisfactory weight gain and cyanotic attacks. The cyanotic attacks had been noticed during the previous month, and were not associated with feeding. They were not accompanied 252