Caron C, Montambault P, Nawar T, Plante G E, Kandalaft N
Can Med Assoc J. 1977 Jun 18;116(12):1359-63.
Three cases of compulsive polydipsia previously diagnosed as diabetes insipidus are presented. Abnormally dilated bladder and pyelocalyceal systems were accompanying features, as previously described for diabetes insipidus, particularly of renal orign. Results of the hypertonic saline (Hickey-Hare) test were positive in only one case. Results of restriction of liquids followed by intravenous injection of vasopressin (Miller test) favoured a diagnosis of complete diabetes insipidus. These two tests cannot, therefore, exclude compulsive polydipsia. The features suggesting a diagnosis of compulsive water drinking are low plasma osmolality, a decrease in 24-hour urine output following water restriction, and abnormal behaviour. The diagnosis is confirmed by an 18-hour dehydration test done after gradual fluid restriction, which favours partial restoration of the papillary osmotic gradient.
本文报告了3例先前被诊断为尿崩症的强迫性烦渴病例。膀胱和肾盂肾盏系统异常扩张是伴随特征，如先前所述的尿崩症，尤其是肾源性尿崩症。高渗盐水（希基-黑尔）试验仅1例结果为阳性。限液后静脉注射血管加压素（米勒试验）的结果支持完全性尿崩症的诊断。因此，这两项试验不能排除强迫性烦渴。提示强迫性饮水诊断的特征是血浆渗透压降低、限水后24小时尿量减少以及行为异常。通过在逐渐限液后进行的18小时脱水试验确诊，该试验有利于乳头渗透梯度的部分恢复。
