Mentrasti Giulia, Scortichini Laura, Torniai Mariangela, Giampieri Riccardo, Morgese Francesca, Rinaldi Silvia, Berardi Rossana
Clinica Oncologica, Università Politecnica delle Marche, AOU Ospedali Riuniti Di Ancona, Ancona, Italy.
Ther Clin Risk Manag. 2020 Jul 24;16:663-672. doi: 10.2147/TCRM.S206066. eCollection 2020.
Hyponatremia, defined as serum sodium concentration <135 mEq/l, is the most common electrolyte balance disorder in clinical practice. Many causes are listed, but syndrome of inappropriate antidiuretic hormone secretion (SIADH) is certainly the most relevant, mainly in oncological and hospitalized patients. In this review, the pathophysiological and clinical aspects are described in detail. Patients' extensive medical history and structured physical and biochemical tests are considered the milestones marking the way of the SIADH management as to provide early detection and proper correction. We focused our attention on the poor prognostic role and negative effect on patient's quality of life of SIADH-induced hyponatremia in both malignant and non-malignant settings, stressing how optimal management of this electrolyte imbalance can result in improved outcomes and lower health costs.
低钠血症定义为血清钠浓度<135 mEq/L，是临床实践中最常见的电解质平衡紊乱。其病因众多，但抗利尿激素分泌不当综合征（SIADH）无疑是最相关的病因，主要见于肿瘤患者和住院患者。在本综述中，将详细描述其病理生理和临床方面。患者全面的病史以及系统的体格检查和生化检查被视为SIADH管理过程中的关键节点，有助于早期发现并进行恰当纠正。我们重点关注了SIADH所致低钠血症在恶性和非恶性情况下对患者预后的不良影响及其对患者生活质量的负面影响，强调了对这种电解质失衡进行优化管理如何能够改善治疗效果并降低医疗成本。
