与噻嗪类利尿剂使用相关的严重低钠血症。

Severe hyponatremia associated with thiazide diuretic use.

作者信息

Sardar Gurkiran K, Eilbert Wesley P

机构信息

Department of Emergency Medicine, University of Illinois Hospital & Health Sciences System, University of Illinois College of Medicine, Chicago, Illinois.

出版信息

J Emerg Med. 2015 Mar;48(3):305-9. doi: 10.1016/j.jemermed.2014.09.054. Epub 2014 Dec 8.

DOI:10.1016/j.jemermed.2014.09.054

PMID:25499401

Abstract

BACKGROUND

Thiazide diuretics are commonly used as first-line antihypertensive agents. Hyponatremia is a reported, though uncommon, complication of thiazide use. Although the exact mechanism of thiazide-induced hyponatremia (TIH) is unclear, it can be a significant cause of morbidity and mortality.

CASE REPORT

We report a 69-year-old man with generalized weakness beginning 2 weeks after starting hydrochlorothiazide (HCTZ). Evaluation revealed a serum sodium level of 120 mmol/L. The patient was admitted and successfully treated with free water restriction and discontinuation of the HCTZ. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Hyponatremia is an uncommon complication of thiazide diuretic use, which frequently presents with nonspecific symptoms. Identification of TIH is crucial to prevent its potentially life-threatening complications.

摘要

背景

噻嗪类利尿剂通常用作一线抗高血压药物。低钠血症是噻嗪类药物使用后报告的一种并发症，尽管并不常见。虽然噻嗪类药物引起低钠血症（TIH）的确切机制尚不清楚，但它可能是发病和死亡的一个重要原因。

病例报告

我们报告一名69岁男性，在开始使用氢氯噻嗪（HCTZ）2周后出现全身无力。检查发现血清钠水平为120 mmol/L。该患者入院后通过限制自由水摄入和停用HCTZ成功得到治疗。急诊医生为何应了解这一情况？：低钠血症是噻嗪类利尿剂使用的一种罕见并发症，常表现为非特异性症状。识别TIH对于预防其潜在的危及生命的并发症至关重要。