A prospective study on hyponatraemia in medical cancer patients: epidemiology, aetiology and differential diagnosis
A prospective study on hyponatraemia in medical cancer patients: epidemiology, aetiology and differential diagnosis
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DOI：
10.1007/s005200050284
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发表时间：
2000-05-01
影响因子：
3.1
通讯作者：
Body, JJ
中科院分区：
文献类型：
--
作者：
Berghmans, T;Paesmans, M;Body, JJ
在综合医院的系列报道中，低钠血症的发生率从不到1%到超过40%不等。我们在一家专门的肿瘤医院进行了一项前瞻性研究，以评估其发病率并确定低钠血症的类型。所有入医学部的患者都进行了为期11个月的前瞻性研究。低钠血症定义为血清钠水平小于或等于130 mEq/l。在基线时收集尿液和血液样本，并研究所有连续的低钠血症发作。106例患者出现123次低钠血症发作。观察到低钠血症发生率为3.7%。钠耗竭和抗利尿激素分泌不当综合征（SIADH）各占所有病因的近三分之一。血清尿素、尿酸、尿钠及钠、尿素分值对鉴别诊断最有用。在低钠血症组中观察到的死亡率为19.5%，高于整个癌症人群（6.3%），尽管没有明显的直接由低钠血症引起的死亡。低钠血症在癌症患者中经常被诊断出来，但只有大约三分之一的病例与SIADH有关。低血氧患者的死亡率高于正常血氧患者。
The frequency of hyponatraemia varies from less than 1% to more than 40% in series reported from general hospitals. We performed a prospective study to evaluate its incidence and to determine the types of hyponatraemia in a dedicated cancer hospital. All patients admitted to the Department of Medicine were prospectively studied over 11 months. Hyponatraemia was defined as a serum Na level less than or equal to 130 mEq/l. Urine and blood samples were collected at baseline, and all consecutive hyponatraemic episodes were studied. One hundred and six patients developed 123 episodes of hyponatraemia. The observed incidence of hyponatraemia was 3.7%. Sodium depletion and syndrome of inappropriate antidiuretic hormone secretion (SIADH) each accounted for almost one third of all aetiologies. Serum urea and uric acid, urinary Na and fractional excretions of Na and urea were most useful for the differential diagnosis. The percentage of deaths observed in the hyponatraemic group, 19.5%, was higher than in the whole cancer population (6.3%) although no death was apparently due directly to hyponatraemia. Hyponatraemia is regularly diagnosed in cancer patients, but it was related to SIADH in only about one third of the cases. A higher mortality was observed in hyponatraemic patients than in normonatraemic patients.