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抗利尿激素分泌异常综合征

Syndrome of Inappropriate Antidiuresis.

作者信息

Moritz Michael L

机构信息

Pediatric Nephrology, Pediatric Dialysis, Division of Nephrology, Department of Pediatrics, UPMC Children's Hospital of Pittsburgh, The University of Pittsburgh School of Medicine, 4401 Penn Avenue, Pittsburgh, PA 15224, USA.

出版信息

Pediatr Clin North Am. 2019 Feb;66(1):209-226. doi: 10.1016/j.pcl.2018.09.005.

Abstract

The syndrome of inappropriate antidiuresis (SIAD) is a common cause of hyponatremia in hospitalized children. SIAD refers to euvolemic hyponatremia due to nonphysiologic stimuli for arginine vasopressin production in the absence of renal or endocrine dysfunction. SIAD can be broadly classified as a result of tumors, pulmonary or central nervous system disorders, medications, or other causes such as infection, inflammation, and the postoperative state. The presence of hypouricemia with an elevated fractional excretion of urate can aid in the diagnosis. Treatment options include fluid restriction, intravenous saline solutions, oral sodium supplements, loop diuretics, oral urea, and vasopressin receptor antagonists (vaptans).

摘要

抗利尿激素分泌失调综合征(SIAD)是住院儿童低钠血症的常见原因。SIAD是指在无肾脏或内分泌功能障碍的情况下,由于精氨酸加压素产生的非生理性刺激而导致的血容量正常性低钠血症。SIAD可大致分为肿瘤、肺部或中枢神经系统疾病、药物或其他原因(如感染、炎症和术后状态)所致。低尿酸血症伴尿酸排泄分数升高有助于诊断。治疗选择包括液体限制、静脉输注生理盐水、口服补钠、襻利尿剂、口服尿素和血管加压素受体拮抗剂(vaptans)。

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