Draper Stephen B, Mori Kate J, Lloyd-Owen Simon, Noakes Timothy
University of Gloucestershire, Sport, Health and Social Care, Oxstalls Campus, Oxstalls Lane, Gloucester GL2 9HW, UK.
BMJ Case Rep. 2009;2009. doi: 10.1136/bcr.09.2008.1002. Epub 2009 Mar 27.
We report a case of overdrinking-induced hyponatraemia from the 2007 London Marathon. The patient was a 37-year-old experienced female marathon runner. She was brought to the emergency room more than 6 h after completing the marathon suffering from diarrhoea, vomiting and confusion, and was unable to recall any detail of the race. An arterial blood sample confirmed hyponatraemia ([Na(+)] 117 mmol.l(-1)) associated with hypokalaemia (serum potassium concentration 3.4 mmol.l(-1)) and respiratory alkalosis (pH 7.62, bicarbonate 16.1 mmol.l(-1) and Pco(2) 2.14 kPa). A diagnosis of uncomplicated exercise-associated hyponatraemia due to voluntary overdrinking was made and the patient was catherised and treated with a slow (1 h) intra-venous infusion of 500 ml of 1.8% sodium chloride (NaCl) solution. The following morning her serum [Na(+)] had normalised at 135 mmol.l(-1) and she was discharged in the afternoon. She has recovered fully without sequelae.
我们报告一例2007年伦敦马拉松比赛中因过度饮水导致低钠血症的病例。患者为一名37岁经验丰富的女性马拉松运动员。她在完成马拉松比赛6个多小时后被送往急诊室，出现腹泻、呕吐和意识模糊症状，且无法回忆起比赛的任何细节。一份动脉血样本证实存在低钠血症（[Na⁺] 117 mmol·L⁻¹），伴有低钾血症（血清钾浓度3.4 mmol·L⁻¹）和呼吸性碱中毒（pH 7.62，碳酸氢盐16.1 mmol·L⁻¹，二氧化碳分压2.14 kPa）。诊断为因自愿过度饮水导致的单纯性运动相关性低钠血症，患者接受了导尿，并通过缓慢（1小时）静脉输注500毫升1.8%氯化钠（NaCl）溶液进行治疗。第二天早晨，她的血清[Na⁺]恢复正常，为135 mmol·L⁻¹，下午出院。她已完全康复，无后遗症。
