Cotton M F, Donald P R, Schoeman J F, Aalbers C, Van Zyl L E, Lombard C
Department of Pediatrics and Child Health, University of Stellenbosch, Republic of South Africa.
Pediatr Infect Dis J. 1991 Nov;10(11):837-42. doi: 10.1097/00006454-199111000-00009.
Biochemical evidence of the syndrome of inappropriate antidiuretic hormone secretion (SIADH) was documented in 17 of 24 (71%) children with tuberculous meningitis. Plasma arginine vasopressin concentrations in patients with signs of SIADH were significantly higher (median, 15.44 (range, 1.62 to greater than 24.52) pg/ml; n = 14) than those without (median, 1.91 (range, 0.44 to 4.91) pg/ml; n = 6) (P less than 0.002). Patients who developed evidence of SIADH were older than those who did not (median, 34 (range, 6 to 101) months vs. 10 (range, 6 to 38) months; P less than 0.007). Five patients with and none without died. In 9 patients evidence of SIADH developed only after hospitalization. These patients received a median of 58 (range, 28 to 109) ml/kg/day fluids (n = 7) before developing evidence of SIADH compared with 107 (range, 58 to 146) ml/kg/day received by patients who did not develop SIADH (n = 6) (P = 0.035). SIADH occurs commonly and its presence appears to influence the outcome of tuberculous meningitis in children.
24名结核性脑膜炎患儿中有17名（71%）记录到抗利尿激素分泌异常综合征（SIADH）的生化证据。出现SIADH体征的患者血浆精氨酸加压素浓度显著高于未出现的患者（中位数，15.44（范围，1.62至大于24.52）pg/ml；n = 14）（中位数，1.91（范围，0.44至4.91）pg/ml；n = 6）（P<0.002）。出现SIADH证据的患者比未出现的患者年龄大（中位数，34（范围，6至101）个月对10（范围，6至38）个月；P<0.007）。5名出现SIADH的患者死亡，未出现的患者无死亡。9名患者的SIADH证据仅在住院后出现。这些患者在出现SIADH证据之前接受的液体量中位数为58（范围，28至109）ml/kg/天（n = 7），而未出现SIADH的患者接受的液体量为107（范围，58至146）ml/kg/天（n = 6）（P = 0.035）。SIADH在儿童结核性脑膜炎中常见，其出现似乎会影响疾病转归。
