Harrigan M R
Department of Surgery, Section of Neurosurgery, University of Michigan, Ann Arbor, Michigan, USA.
Crit Care Clin. 2001 Jan;17(1):125-38. doi: 10.1016/s0749-0704(05)70155-x.
There is significant evidence to show that many patients with hyponatremia and intracranial disease who were previously diagnosed with SIADH actually have CSW. The critical difference between SIADH and CSW is that CSW involves renal salt loss leading to hyponatremia and volume loss, whereas SIADH is a euvolemic or hypervolemic condition. Attention to volume status in patients with hyponatremia is essential. The primary treatment for CSW is water and salt replacement. The mechanisms underlying CSW are not understood but may involve ANP or other natriuretic factors and direct neural influence on renal function. Future investigation is needed to better define the incidence of CSW in patients with intracranial disease, identify other disorders that can lead to CSW, and elucidate the mechanisms underlying this syndrome.
有大量证据表明，许多先前被诊断为抗利尿激素分泌异常综合征（SIADH）的低钠血症和颅内疾病患者实际上患有脑性盐耗综合征（CSW）。SIADH和CSW之间的关键区别在于，CSW涉及肾盐丢失导致低钠血症和容量丢失，而SIADH是一种等容或高容状态。关注低钠血症患者的容量状态至关重要。CSW的主要治疗方法是补充水和盐。CSW的潜在机制尚不清楚，但可能涉及心钠素或其他利钠因子以及对肾功能的直接神经影响。需要进一步研究以更好地确定颅内疾病患者中CSW的发生率，识别其他可导致CSW的疾病，并阐明该综合征的潜在机制。
