Cerdà-Esteve M, Cuadrado-Godia E, Chillaron J J, Pont-Sunyer C, Cucurella G, Fernández M, Goday A, Cano-Pérez J F, Rodríguez-Campello A, Roquer J
Endocrinology Department, Hospital Universitari del Mar, Universitat Autònoma de Barcelona, Barcelona, Spain.
Eur J Intern Med. 2008 Jun;19(4):249-54. doi: 10.1016/j.ejim.2007.06.019. Epub 2008 Mar 7.
Hyponatremia is the most frequent electrolyte disorder in critically neurological patients. Cerebral salt wasting syndrome (CSW) is defined as a renal loss of sodium during intracranial disease leading to hyponatremia and a decrease in extracellular fluid volume. The pathogenesis of this disorder is still not completely understood. Sympathetic responses as well as some natriuretic factors play a role in this syndrome. Distinction between SIADH and CSW might be difficult. The essential point is the volemic state. It is necessary to rule out other intermediate causes. Treatment requires volume replacement and maintenance of a positive salt balance. Mineral corticoids may be useful in complicated cases.
低钠血症是重症神经科患者中最常见的电解质紊乱。脑性盐耗综合征（CSW）被定义为颅内疾病期间肾脏失钠，导致低钠血症和细胞外液量减少。这种疾病的发病机制仍未完全明确。交感反应以及一些利钠因子在该综合征中起作用。抗利尿激素分泌不当综合征（SIADH）和CSW之间的鉴别可能困难。关键在于容量状态。有必要排除其他中间原因。治疗需要补充容量并维持正盐平衡。在复杂病例中，盐皮质激素可能有用。
