Gerigk M, Bald M, Feth F, Rascher W
Klinik für Kinder- und Jugendmedizin, Universitätsklinikum Essen (GHS), Germany.
Eur J Pediatr. 1993 Apr;152(4):301-5. doi: 10.1007/BF01956738.
Hyponatraemia is one of the most common electrolyte abnormalities in hospitalised children. In a prospective study we tested whether hyponatraemia is associated with sustained release of the antidiuretic hormone arginine vasopressin (AVP). Out of 27 children with persistent hyponatremia (serum sodium < 130 mmol/l), 25 had measurable plasma concentrations of AVP [median and quartiles 5.0 pg/ml (1.5-8.3)]. Volume contraction as consequence of sodium loss caused hyponatraemia in 16 patients. Hyponatraemia in the presence of extracellular volume expansion and reduced effective arterial blood volume occurred in 5 patients. Only 3 patients had normovolaemic hyponatraemia (so-called syndrome of inappropriate antidiuretic hormone secretion) and 3 suffered from chronic renal failure. It is concluded that plasma AVP concentration is measurable in most children with hyponatraemia. Non-osmotic stimulation of AVP release and lack of suppression of this hormone is an important pathogenetic mechanism of hyponatraemia in children.
低钠血症是住院儿童中最常见的电解质异常之一。在一项前瞻性研究中，我们测试了低钠血症是否与抗利尿激素精氨酸加压素（AVP）的持续释放有关。在27例持续性低钠血症（血清钠<130 mmol/L）儿童中，25例血浆AVP浓度可测[中位数和四分位数为5.0 pg/ml（1.5 - 8.3）]。因钠丢失导致的容量收缩在16例患者中引起低钠血症。5例患者出现细胞外液量扩张和有效动脉血容量减少时的低钠血症。只有3例患者为等容性低钠血症（所谓的抗利尿激素分泌不当综合征），3例患有慢性肾衰竭。得出的结论是，大多数低钠血症儿童的血浆AVP浓度是可测的。AVP释放的非渗透性刺激以及该激素缺乏抑制是儿童低钠血症的重要发病机制。
