Norenberg M D, Leslie K O, Robertson A S
Ann Neurol. 1982 Feb;11(2):128-35. doi: 10.1002/ana.410110204.
Twelve hyponatremic patients with central pontine myelinolysis (CPM) showed a rise in serum sodium levels 3 to 10 days (mean, 6) prior to the development of CPM. The increase exceeded 20 mEq/L within 1 to 3 days and was then sustained for an additional 3 to 5 days. In addition, 11 of the 12 CPM patients achieved a sodium value of 147 mEq/L or greater during the period of sodium elevation. The rise in sodium frequently coincided with administration of saline solutions, diuretics, steroids, and lactulose. In contrast, 9 hyponatremic patients who did not have CPM showed sodium increases that were significantly less or slower (or both) following treatment of hyponatremia. Our findings suggest that CPM may be caused by a too rapid or excessive rise in serum sodium from a hyponatremic baseline.
12例患有渗透性脱髓鞘综合征（CPM）的低钠血症患者在CPM发生前3至10天（平均6天）血清钠水平升高。在1至3天内升高超过20 mEq/L，然后再持续3至5天。此外，12例CPM患者中有11例在血清钠升高期间达到147 mEq/L或更高的值。钠升高常常与给予盐溶液、利尿剂、类固醇和乳果糖同时发生。相比之下，9例未患CPM的低钠血症患者在低钠血症治疗后钠升高明显较少或较慢（或两者兼有）。我们的研究结果表明，CPM可能由低钠血症基线时血清钠过快或过度升高所致。
