EISENBERG E
Calif Med. 1965 May;102(5):353-8.
Frequent errors in the diagnosis of diabetes insipidus arise from (1) failure to produce an adequate stimulus for release of antidiuretic hormone, and (2) failure to appreciate acute or chronic changes in renal function that may obscure test results. Properly timed determination of body weight, urine volume and serum and urine osmolarity during the course of water deprivation, and comparison of these values with those obtained after administration of exogenous vasopressin, eliminates most diagnostic errors. In four patients who had experienced local and systemic reactions to other exogenous forms of vasopressin, diabetes insipidus was satisfactorily controlled by administration of synthetic lysine-8 vasopressin in nasal spray. A fifth patient was also treated satisfactorily with this preparation.
(1)未能产生足够的刺激以释放抗利尿激素;(2)未能认识到可能掩盖检测结果的肾功能急性或慢性变化。在禁水过程中适时测定体重、尿量以及血清和尿液渗透压,并将这些值与给予外源性血管加压素后获得的值进行比较,可消除大多数诊断错误。在4例对其他外源性血管加压素形式有局部和全身反应的患者中,通过鼻腔喷雾给予合成赖氨酸 - 8血管加压素可令人满意地控制尿崩症。第5例患者使用该制剂治疗也取得了满意效果。