Douglas Ivor
Medical Intensive Care, Denver Health Medical Center University of Colorado at Denver and Health Sciences Center Denver, CO 80204, USA.
Cleve Clin J Med. 2006 Sep;73 Suppl 3:S4-12. doi: 10.3949/ccjm.73.suppl_3.s4.
Hyponatremia is a common electrolyte disorder among hospitalized patients and has been associated with increased mortality. Most patients are asymptomatic, but many do present with symptoms, usually of a generalized neurologic nature. Based-on medical history, physical examination (including volume-status assessment), and laboratory tests, patients can be classified as having either hypervolemic, euvolemic, or hypovolemic hyponatremia. Management depends on the speed of hyponatremia onset; its degree, duration, and symptoms; and whether there are risk factors for neurologic complications. The risks of overly rapid correction must be weighed against the benefits of treating hyponatremia. Traditional therapies have significant limitations. New agents that antagonize arginine vasopressin at the V2 receptor or both the V(1A) and V2 receptors show promise for treating hypervolemic and euvolemic hyponatremia, as they induce desired free water diuresis without inducing sodium excretion.
低钠血症是住院患者中常见的电解质紊乱，且与死亡率增加相关。大多数患者无症状，但许多患者确实会出现症状，通常具有全身性神经症状。根据病史、体格检查（包括容量状态评估）和实验室检查，患者可分为高容量性、等容量性或低容量性低钠血症。治疗取决于低钠血症的起病速度、程度、持续时间和症状，以及是否存在神经并发症的危险因素。必须权衡过快纠正的风险与治疗低钠血症的益处。传统疗法有显著局限性。在V2受体或同时在V(1A)和V2受体拮抗精氨酸加压素的新型药物，有望治疗高容量性和等容量性低钠血症，因为它们可诱导所需的自由水利尿而不诱导钠排泄。
