頸髄損傷後に発生した重症低ナトリウム血症の1例—経時的血液生化学的検討による考察

Severe Hyponatremia in a Case of Severe Spinal Injury : Sequential Examination of Factors Affecting Water-electrolyte Balance

　重症脊髄損傷後は亜急性期に低ナトリウム血症を高率に合併するが，その発症機序は明らかではない。頸髄損傷後に重症の低ナトリウム血症を合併した64歳の男性について，数カ月にわたり水分，ナトリウム出納や血液中関連ペプチドを測定したのでその結果を報告するとともに，自律神経機能を含めた発症機序について考察する。

Although hyponatremia has been known to occur in patients with severe spinal cord injury with highly inci-dence, its mechanism has not been understood well. We examined a 64-year-old patient with severe hy-ponatremia after spinal cord injury by sequential measuring of the factors affecting water-electrolyte balance, such as antidiuretic hormone, renin, an-giotensin Ⅱ, atrial natriuretic peptide, and brain natriu-retic peptide. The patient showed severe hypotension due to dysfunction of the sympathetic nerve. The hy-ponatremia gradually resolved with the improvement of sympathetic nerve function.