Blevins L S, Wand G S
Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD.
Crit Care Med. 1992 Jan;20(1):69-79. doi: 10.1097/00003246-199201000-00019.
To review the pathophysiology, diagnosis, and treatment of the syndromes of diabetes insipidus with an emphasis on those situations likely to be encountered in the critical care setting.
Extensive clinical experience and relevant publications from the English literature identified via MEDLINE search, citation in reviews, publications of original data, and endocrine texts.
Landmark papers pertaining to all aspects of diabetes insipidus were selected. Reviews, primary articles, and case reports pertaining to diabetes insipidus in the critical care setting were identified and selected according to their content of clinically useful information.
Diabetes insipidus may result from impaired synthesis and release of vasopressin from the hypothalamic-pituitary unit (neurogenic) or renal insensitivity to circulating vasopressin (nephrogenic). A number of interventions, diseases, and drugs commonly encountered in the critical care setting may result in the development or exacerbation of diabetes insipidus. The diagnosis of diabetes insipidus requires the exclusion of other causes of polyuria and a systematic demonstration of the response of homeostatic mechanisms to controlled dehydration. The treatment of diabetes insipidus depends on many factors, including the clinical setting, degree and pathophysiologic classification, ability of the patient to compensate for free water losses, and expected duration of the abnormality. Underlying disorders should be treated appropriately whenever possible.
回顾尿崩症的病理生理学、诊断及治疗，重点关注重症监护环境中可能遇到的情况。
通过医学文献数据库检索、综述中的引用、原始数据出版物及内分泌学教材确定的广泛临床经验和英文文献中的相关出版物。
选取与尿崩症各方面相关的标志性论文。根据其临床有用信息的内容，确定并选择与重症监护环境中尿崩症相关的综述、主要文章及病例报告。
尿崩症可能由下丘脑 - 垂体单位抗利尿激素合成与释放受损（神经源性）或肾脏对循环中抗利尿激素不敏感（肾源性）引起。重症监护环境中常见的一些干预措施、疾病和药物可能导致尿崩症的发生或加重。尿崩症的诊断需要排除其他多尿原因，并系统证明稳态机制对控制性脱水的反应。尿崩症的治疗取决于许多因素，包括临床情况、程度和病理生理分类、患者补偿自由水丢失的能力以及异常情况的预期持续时间。只要可能，应适当治疗潜在疾病。
