George J, Thomas K, Jeyaseelan L, Peter J V, Cherian A M
Christian Medical College, Tamil Nadu, India.
Natl Med J India. 1996 May-Jun;9(3):107-9.
Hiccups are observed in many patients with hypohatraemia. We performed a case-control study to evaluate their association in a referral teaching hospital in South India.
Fifty consecutive patients who developed hiccups during an 18-month period were studied. They were categorized according to age group and diagnosis and controls matched for age and sex were selected from patients admitted on the same day in the medical wards. Hiccups were graded on a four-point severity scale at recruitment and every day till day 7 or till hiccups subsided.
The step-wise logistic regression analysis done to establish independent association showed that for every 10 mEq/L reduction in serum sodium, patients were 17 times (p = 0.001; confidence interval: 4-87) at risk of developing hiccups. The only other significant determinant of the symptom was the diagnostic category of renal failure (odds ratio = 128; confidence interval: 1-1420). The number of patients who had hyponatraemia with varying severity of hiccups showed a dose-response relationship. The crude odds ratios were 7, 58 and 320 for mild, moderate and severe hiccups.
There is a strong and independent association between hyponatraemia and hiccups in hospitalized patients. A causative association is suggested by the dose-response relationship demonstrated in the study. In many hospitals in developing countries where measurement of serum sodium is difficult and unreliable, it is important to be aware of this association since it can be easily corrected.
许多低钠血症患者会出现打嗝症状。我们在印度南部一家转诊教学医院进行了一项病例对照研究，以评估二者之间的关联。
对18个月期间连续出现打嗝症状的50例患者进行研究。根据年龄组和诊断进行分类，并从同日入住内科病房的患者中选取年龄和性别相匹配的对照。在纳入研究时以及直至第7天或打嗝症状消失前，每天根据四点严重程度量表对打嗝进行分级。
为确定独立关联而进行的逐步逻辑回归分析显示，血清钠每降低10 mEq/L，患者出现打嗝的风险就会增加17倍（p = 0.001；置信区间：4 - 87）。该症状的唯一其他重要决定因素是肾衰竭的诊断类别（比值比 = 128；置信区间：1 - 1420）。低钠血症且打嗝严重程度不同的患者数量呈现剂量反应关系。轻度、中度和重度打嗝的粗比值比分别为7、58和320。
住院患者中低钠血症与打嗝之间存在强烈且独立的关联。研究中显示的剂量反应关系提示了因果关联。在发展中国家的许多医院，血清钠测量困难且不可靠，了解这种关联很重要，因为它很容易得到纠正。
