老年人严重利尿剂诱发的低钠血症。八例患者系列报道。

Severe diuretic-induced hyponatremia in the elderly. A series of eight patients.

作者信息

Ashouri O S

出版信息

Arch Intern Med. 1986 Jul;146(7):1355-7.

Abstract

Eight elderly patients with severe diuretic-induced hyponatremia (mean serum sodium level [+/- SD], 110 +/- 2 mEq/L [110 +/- 2 mmol/L]) and overt neurological manifestations were treated with 3% sodium chloride. Within 28.8 +/- 6 hours of treatment, the serum sodium level was corrected to 132 +/- 5.6 mEq/L (132 +/- 5.6 mmol/L), indicating a correction rate of 0.78 +/- 0.26 mEq/L/h (0.78 +/- 0.26 mmol/L/h). Seven of the eight patients recovered from the neurological insult and were discharged from the hospital. One patient died of an unrelated illness. Severe diuretic-induced hyponatremia seems to be predisposed by age, sex, and body weight. Patients with this entity are usually old, female, and underweight. Associated conditions (eg, intractable diarrhea, tube feeding, hypoglycemic drugs, polydipsia, and cerebrovascular accidents) may play a role in the pathogenesis of the syndrome.

摘要

8例因使用利尿剂导致严重低钠血症（血清钠平均水平[±标准差]为110±2 mEq/L[110±2 mmol/L]）且伴有明显神经症状的老年患者接受了3%氯化钠治疗。在治疗的28.8±6小时内，血清钠水平校正至132±5.6 mEq/L（132±5.6 mmol/L），校正速率为0.78±0.26 mEq/L/h（0.78±0.26 mmol/L/h）。8例患者中有7例神经损伤恢复并出院。1例患者死于无关疾病。严重的利尿剂所致低钠血症似乎与年龄、性别和体重有关。患有该疾病的患者通常为老年女性且体重过轻。相关情况（如顽固性腹泻、管饲、降糖药物、烦渴和脑血管意外）可能在该综合征的发病机制中起作用。