Human cerebral osmolytes during chronic hyponatremia. A proton magnetic resonance spectroscopy study.
Human cerebral osmolytes during chronic hyponatremia. A proton magnetic resonance spectroscopy study.
复制标题
慢性低钠血症期间的人脑渗透压。
DOI：
10.1172/jci117728
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发表时间：
1995
期刊：
影响因子：
--
通讯作者：
Ross,BD
中科院分区：
文献类型：
--
作者：
Videen,JS;Michaelis,T;Pinto,P;Ross,BD
与低钠血症相关的发病机制被认为是由细胞内脑渗透压物质的状态决定的。以前无法访问，这些代谢物现在可以通过质子磁共振光谱定量。在12例慢性低钠血症患者（平均血清钠120毫克当量/升）和10名正常对照组的渗透压在体内进行定量测定。枕部灰质和顶叶白色物质位置的短回波时间质子磁共振波谱显示几种代谢物的浓度急剧降低。在灰质中，肌醇最深刻地减少了49%的控制值。与对照组相比，含胆碱化合物减少36%，肌酸/磷酸肌酸减少19%，N-乙酰天冬氨酸减少11%。在白色物质中也发现了类似的变化。在8-14周后研究的4例患者中证实了渗透压浓度的恢复。这些结果与完整人脑在低渗压力下的可逆渗透压降低一致，并为治疗和监测这一常见临床事件提供了新的建议。图片
The pathogenesis of morbidity associated with hyponatremia is postulated to be determined by the state of intracellular cerebral osmolytes. Previously inaccessible, these metabolites can now be quantitated by proton magnetic resonance spectroscopy. An in vivo quantitative assay of osmolytes was performed in 12 chronic hyponatremic patients (mean serum sodium 120 meq/liter) and 10 normal controls. Short echo time proton magnetic resonance spectroscopy of occipital gray and parietal white matter locations revealed dramatic reduction in the concentrations of several metabolites. In gray matter, myo-inositol was most profoundly reduced at 49% of control value. Choline containing compounds were reduced 36%, creatine/phosphocreatine 19%, and N-acetylaspartate 11% from controls. Similar changes were found in white matter. Recovery of osmolyte concentrations was demonstrated in four patients studied 8-14 wk later. These results are consistent with a reversible osmolyte reduction under hypoosmolar stress in the intact human brain and offer novel suggestions for treatment and monitoring of this common clinical event.Images