Friedman A L, Segar W E
J Pediatr. 1979 Apr;94(4):521-6. doi: 10.1016/s0022-3476(79)80003-7.
Known physiologic mechanisms explain the elevated blood ADH levels observed in most patients with the syndrome of inappropriate ADH. Therefore the word "inappropriate" is a misnomer. It implies that the mechanisms that regulate ADH release are not functioning normally--which is not true. The term misleads the physician who, ideally, should determine why a patient has an excessive blood ADH level and initiate appropriate treatment. Patients with ectopic production of ADH and hyponatremia should be so labeled: "Hyponatremia due to ectopic ADH production." The term SIADH, if used at all, should be reserved for the rare patient with CNS injury or disease that causes increased ADH release and in which the hypothalamic center does not respond normally to afferent peripheral stimuli.
已知的生理机制可以解释大多数抗利尿激素分泌不当综合征患者血液中抗利尿激素水平升高的现象。因此,“不当”这个词是用词不当。它意味着调节抗利尿激素释放的机制没有正常发挥作用——但事实并非如此。这个术语误导了医生,理想情况下,医生应该确定患者血液中抗利尿激素水平过高的原因并采取适当的治疗措施。患有抗利尿激素异位分泌和低钠血症的患者应该这样标记:“异位抗利尿激素分泌导致的低钠血症”。如果一定要使用抗利尿激素分泌不当综合征(SIADH)这个术语,应该只用于极少数因中枢神经系统损伤或疾病导致抗利尿激素释放增加且下丘脑中心对传入的外周刺激没有正常反应的患者。