Raftopoulos Harry
Columbia University, New York, NY 10032, USA.
Support Care Cancer. 2007 Dec;15(12):1341-7. doi: 10.1007/s00520-007-0309-9. Epub 2007 Aug 14.
Hyponatremia is among the metabolic disturbances encountered in oncology. Risk factors for hyponatremia include chemotherapy, treatment-induced nausea and vomiting, hydration, pain, narcotic drugs, and physical and emotional stress. A common cause of hyponatremia in patients with cancer is the syndrome of inappropriate secretion of antidiuretic hormone (SIADH), which may result from ectopic production of arginine vasopressin (AVP) by the tumor tissue.
The AVP-receptor antagonists, a new class of agents, correct hyponatremia by directly blocking the binding of AVP with its receptors. In clinical trials, conivaptan, lixivaptan, tolvaptan, and satavaptan have increased serum osmolality and normalized the serum [Na(+)] in hyponatremia associated with SIADH, cirrhosis, or congestive heart failure. These drugs may have a potential in cancer-related hyponatremia as well.
低钠血症是肿瘤学中遇到的代谢紊乱之一。低钠血症的危险因素包括化疗、治疗引起的恶心和呕吐、补液、疼痛、麻醉药物以及身体和情绪应激。癌症患者低钠血症的常见原因是抗利尿激素不适当分泌综合征（SIADH），这可能是由于肿瘤组织异位产生精氨酸加压素（AVP）所致。
AVP受体拮抗剂是一类新型药物，通过直接阻断AVP与其受体的结合来纠正低钠血症。在临床试验中，考尼伐坦、利伐普坦、托伐普坦和萨特伐普坦可提高血清渗透压，并使与SIADH、肝硬化或充血性心力衰竭相关的低钠血症患者的血清[Na⁺]恢复正常。这些药物在癌症相关低钠血症中可能也有潜在作用。
