Sonnenblick M, Algur N
Department of Geriatrics, Shaare Zedek Medical Center, Jerusalem, Israel.
Miner Electrolyte Metab. 1993;19(1):32-5.
Hypernatremia, a common finding among the elderly, is believed to be due to water deficit. In the present study, in 12 consecutive hospitalized elderly patients (mean age 82.2 years) with moderate to severe hypernatremia (mean serum sodium 166.9 mEq/l), inappropriately low plasma levels of vasopressin were found in relation to serum osmolality (mean 1.8 pg/ml and 343 mosmol/l, respectively). All patients but 1 were hospitalized with acute febrile disease and all but 2 had underlying neurological disease. Hypernatremia persisted for at least 3 days despite the patients' rehydration. It seems, therefore, that temporary hypernatremia in elderly patients with acute febrile disease, especially in the presence of underlying neurological disorder, reflects an inadequate vasopressin response to the hyperosmolar state.
高钠血症在老年人中很常见，被认为是由于水分缺乏所致。在本研究中，连续纳入了12例中度至重度高钠血症（平均血清钠166.9 mEq/L）的住院老年患者（平均年龄82.2岁），发现相对于血清渗透压（分别为平均1.8 pg/ml和343 mosmol/L），血管加压素的血浆水平异常低。除1例患者外，所有患者均因急性发热性疾病住院，除2例患者外，所有患者均有潜在的神经系统疾病。尽管患者进行了补液，但高钠血症仍持续至少3天。因此，患有急性发热性疾病的老年患者，尤其是存在潜在神经系统疾病时，出现的暂时性高钠血症似乎反映了血管加压素对高渗状态的反应不足。
