Du J, Cao J, Zhao H
Department of Neurological Surgery, Xuanwu Hospital, Beijing.
Zhonghua Wai Ke Za Zhi. 1996 Jul;34(7):436-7.
14 cases of mannitol-induced acute renal failure were reported. The dosage of mannitol used varied widely. In all cases serum Na+, HCO3- were decreased, K+ and BUN increased significantly. Serum osmolality was measured in 5 cases. The osmolal gap was increased greatly, 77.4mOsm/kg. H2O in average. The increase of osmolal gap may play an important role in acute renal failure by causing intensive renal vasocontraction. Monitoring of serum osmolality or osmolal gap can help to prevent mannitol intoxication. The decrease of serum Na+ may be a warning sign of increased osmolal gap. Hemodialysis is the best way for the treatment of mannitol-induced acute renal failure.
报告了14例甘露醇诱发的急性肾衰竭病例。所使用的甘露醇剂量差异很大。所有病例中血清钠、碳酸氢根均降低，钾和尿素氮显著升高。对5例患者测量了血清渗透压。渗透压间隙大幅增加，平均为77.4mOsm/kg·H₂O。渗透压间隙的增加可能通过引起强烈的肾血管收缩在急性肾衰竭中起重要作用。监测血清渗透压或渗透压间隙有助于预防甘露醇中毒。血清钠降低可能是渗透压间隙增加的警示信号。血液透析是治疗甘露醇诱发的急性肾衰竭的最佳方法。
