O'Connor Robert E
Department of Emergency Medicine, Christiana Care Health Services, Newark, DE 19718, USA.
Cleve Clin J Med. 2006 Sep;73 Suppl 3:S13-8. doi: 10.3949/ccjm.73.suppl_3.s13.
Exercise-induced hyponatremia is most commonly associated with prolonged exertion during sustained, high-intensity endurance activities such as marathons or triathlons. In most cases, exercise-induced hyponatremia is attributable to excess free water intake, which fails to replete the sometimes massive sodium losses that result from sweating. The risk of hyponatremia can be lowered by strategies to ensure fluid balance during exercise by maintaining the proper volume and type of fluid intake. Treatment of exercise-induced hyponatremia is based on whether the patient is volume-depleted, euvolemic, or fluid-overloaded. Because therapy must be tailored to volume status, physicians must make this determination before initiating therapy. If hyponatremia is life-threatening, hypertonic saline may be warranted to increase sodium in the extracellular fluid compartment and restore the natural balance.
运动性低钠血症最常与马拉松或铁人三项等持续高强度耐力活动中的长时间运动有关。在大多数情况下，运动性低钠血症归因于过量摄入游离水，而这无法补充出汗导致的有时大量的钠流失。通过在运动期间保持适当的液体摄入量和类型来确保液体平衡的策略，可以降低低钠血症的风险。运动性低钠血症的治疗取决于患者是血容量减少、血容量正常还是液体超负荷。由于治疗必须根据血容量状态进行调整，医生在开始治疗前必须做出这一判断。如果低钠血症危及生命，可能需要使用高渗盐水来增加细胞外液中的钠含量并恢复自然平衡。
