Perschinka Fabian, Köglberger Paul, Klein Sebastian J, Joannidis Michael
Gemeinsame Einrichtung Internistische Intensiv- und Notfallmedizin, Department für Innere Medizin, Medizinische Universität Innsbruck, Anichstraße 35, 6020, Innsbruck, Österreich.
Institut für Anästhesiologie und Intensivmedizin, Klinikum Wels, Grieskirchnerstraße 42, 4600, Wels, Österreich.
Med Klin Intensivmed Notfmed. 2023 Sep;118(6):505-517. doi: 10.1007/s00063-023-01049-0. Epub 2023 Aug 30.
Hyponatremia is one of the most common electrolyte disorders in emergency departments and hospitalized patients. Serum sodium concentration is controlled by osmoregulation and volume regulation. Both pathways are regulated via the release of antidiuretic hormone (ADH). Syndrome of inappropriate release of ADH (SIADH) may be caused by neoplasms or pneumonia but may also be triggered by drug use or drug abuse. Excessive fluid intake may also result in a decrease in serum sodium concentration. Rapid alteration in serum sodium concentration leads to cell swelling or cell shrinkage, which primarily causes neurological symptoms. The dynamics of development of hyponatremia and its duration are crucial. In addition to blood testing, a clinical examination and urine analysis are essential in the differential diagnosis of hyponatremia.
低钠血症是急诊科和住院患者中最常见的电解质紊乱之一。血清钠浓度受渗透压调节和容量调节控制。这两条途径均通过抗利尿激素（ADH）的释放进行调节。抗利尿激素不适当分泌综合征（SIADH）可能由肿瘤或肺炎引起，但也可能由药物使用或药物滥用引发。过量饮水也可能导致血清钠浓度降低。血清钠浓度的快速改变会导致细胞肿胀或细胞萎缩，主要引起神经症状。低钠血症的发展动态及其持续时间至关重要。除血液检测外，临床检查和尿液分析对于低钠血症的鉴别诊断也必不可少。
