HYPONATREMIA - A PROSPECTIVE ANALYSIS OF ITS EPIDEMIOLOGY AND THE PATHOGENETIC ROLE OF VASOPRESSIN
HYPONATREMIA - A PROSPECTIVE ANALYSIS OF ITS EPIDEMIOLOGY AND THE PATHOGENETIC ROLE OF VASOPRESSIN
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DOI：
10.7326/0003-4819-102-2-164
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发表时间：
1985-01-01
影响因子：
39.2
通讯作者：
SCHRIER, RW
中科院分区：
文献类型：
--
作者：
ANDERSON, RJ;CHUNG, HM;SCHRIER, RW
对住院患者进行低钠血症(血浆钠浓度130meq/L)的发生率、病因、转归及激素反应的测定。低钠血症日均发生率为0.97%，患病率为2.48%。三分之二的低钠血症是医院获得性的。等容状态(所谓的抗利尿激素不适当分泌综合征)是最常见的低钠血症的临床环境。低钠血症患者的病死率是无记录的低钠血症患者的60倍。在寻求血管加压素的低钠血症患者中，97%存在加压素的非渗透性分泌。在水肿型和低血容量型患者中，血浆激素反应(血浆肾素活性、醛固酮和去甲肾上腺素水平的增加)与压力感受器介导的加压素释放相一致。低钠血症是一种常见的医院获得性电解质紊乱，是预后不良的指标。精氨酸加压素的非渗透性分泌是这种电解质紊乱的主要致病因素。
The frequency, cause and outcome of hyponatremia (plasma Na concentration, < 130 meq/l), as well as the hormonal response to this condition were measured in hospitalized patients. Daily incidence and prevalence of hyponatremia averaged 0.97% and 2.48%, respectively. Two-thirds of all hyponatremia was hospital acquired. Normovolemic states (so-called syndrome of inappropriate secretion of antidiuretic hormone) were the most commonly seen clinical setting of hyponatremia. The fatality rate for hyponatremic patients was 60-fold that for patients without documented hyponatremia. Nonosmotic secretion of vasopressin was present in 97% of hyponatremic patients in whom it was sought. In edematous and hypovolemic patients, plasma hormonal responses (increases in plasma renin activity and aldosterone and norepinephrine levels) were compatible with baroreceptor-mediated release of vasopressin. Hyponatremia is a common hospital-acquired electrolyte disturbance that is an indicator of poor prognosis. Nonosmotic secretion of arginine vasopressin is a major pathogenetic factor in this electrolyte disturbance.