cerebral edema copeptin osmotic demyelination syndrome urea vasopressin vasopressin receptor antagonist
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摘要

Hyponatremia is a common water balance disorder that often poses a diagnostic or therapeutic challenge. Therefore, guidelines were developed by professional organizations, one from within the United States (2013) and one from within Europe (2014). This review discusses the diagnosis and treatment of hyponatremia, comparing the two guidelines and highlighting recent developments. Diagnostically, the initial step is to differentiate hypotonic from nonhypotonic hyponatremia. Hypotonic hyponatremia is further differentiated on the basis of urine osmolality, urine sodium level, and volume status. Recently identified parameters, including fractional uric acid excretion and plasma copeptin concentration, may further improve the diagnostic approach. The treatment for hyponatremia is chosen on the basis of duration and symptoms. For acute or severely symptomatic hyponatremia, both guidelines adopted the approach of giving a bolus of hypertonic saline. Although fluid restriction remains the first-line treatment for most forms of chronic hyponatremia, therapy to increase renal free water excretion is often necessary. Vasopressin receptor antagonists, urea, and loop diuretics serve this purpose, but received different recommendations in the two guidelines. Such discrepancies may relate to different interpretations of the limited evidence or differences in guideline methodology. Nevertheless, the development of guidelines has been important in advancing this evolving field.

译文

低钠血症是一种常见的水平衡障碍,通常会带来诊断或治疗上的挑战。因此,指导方针是由专业组织制定的,一个来自美国 (2013),一个来自欧洲 (2014)。这篇综述讨论了低钠血症的诊断和治疗,比较了两种指南,并强调了最近的发展。诊断上,第一步是区分低渗和非低渗低钠血症。低渗低钠血症根据尿渗透压、尿钠水平和容量状态进一步分化。最近确定的参数,包括尿酸排泄分数和血浆和肽素浓度,可能会进一步改善诊断方法。低钠血症的治疗是根据持续时间和症状来选择的。对于急性或严重症状性低钠血症,两个指南都采用给予高渗盐水的方法。虽然液体限制仍然是大多数形式的慢性低钠血症的一线治疗,但增加肾脏游离水排泄的治疗通常是必要的。血管加压素受体拮抗剂、尿素和环利尿剂达到了这个目的,但是在两个指南中收到了不同的建议。这种差异可能与对有限证据的不同解释或指导方法的不同有关。然而,制定指导方针对于推进这一不断演变的领域非常重要。

hyponatremia

消化 水盐失衡 疾病
概述  :  

低钠血症的定义为血清钠低于135mmol/L,为临床最常见的水盐失衡类型,其发生率约占住院患者的30%,因其涉及临床学科较广而备受临床医生的关注。 低钠血症的病理生理学分类根据低钠血症的病理生理学机制,可将其分类:(1)假性低钠血症。(2)非低渗性低钠血症:①等渗性低钠血症;②高渗性低钠血症。(3)低渗性低钠血症。1.假性低钠血症:正常血浆含7%容积的固相物质(即含水量为93%)。在实际检验时,为了减少所需血标本量,通常在检测前对血清标本进行稀释。因稀释仅对溶液的液相部分而言,固相

hyponatremia  英 /,haipəunə'tri:miə/   美 /,haɪponə'trimiə/

释义   n. 低钠血症

例句   Drinking only water while you take part in high-energy athletic events can lead to acute hyponatremia. 当你参加高能耗体育活动时,只喝水的话会导致急性的低钠血症。

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