Shiba S, Sugiura K, Ebata A, Kagaya T, Tomori G, Marumo F, Sato C
Department of Internal Medicine, Tokyo Metropolitan Fuchu Hospital, Tokyo, Japan.
Dig Dis Sci. 1996 Aug;41(8):1615-7. doi: 10.1007/BF02087909.
A 68-year-old man developed severe consciousness disturbance after daily administration of 20 mg omeprazole for four days for the treatment of bleeding gastric ulcer. Systemic investigation revealed severe hyponatremia (111 meq/liter). Consciousness did not become clear until his sodium intake was increased to 480 meq/day, and his serum sodium concentrations reached 130 meq/liter. After the discontinuation of omeprazole, his serum sodium levels returned to the normal range with only minimum supplementation of sodium in the form of dietary sodium chloride intake of 10 g/day. Although the mechanism of hyponatremia induced by omeprazole is not clear, an excessive loss of urinary sodium appears to be more likely than water retention with an increase in fluid intake. The literature was also reviewed.
一名68岁男性因治疗出血性胃溃疡，连续四天每日服用20毫克奥美拉唑后出现严重意识障碍。全身检查发现严重低钠血症（111毫当量/升）。直到他的钠摄入量增加到每天480毫当量，血清钠浓度达到130毫当量/升时，意识才变得清醒。停用奥美拉唑后，仅通过每天摄入10克氯化钠形式的膳食钠进行最低限度的钠补充，他的血清钠水平就恢复到了正常范围。虽然奥美拉唑引起低钠血症的机制尚不清楚，但尿钠过度流失似乎比因液体摄入量增加导致水潴留更有可能。同时对相关文献也进行了综述。
