小细胞肺癌合并抗利尿激素分泌异常综合征研究进展

Syndrome of Inappropriate Secretion of Antidiuretic Hormone in Small Cell Lung Cancer

小细胞肺癌(SCLC)患者常合并抗利尿激素分泌异常综合征(SIADH),其原因主要是肿瘤细胞分泌抗利尿激素(ADH)增多,一些化疗药物也可引起ADH释放增加,从而引起体内水钠代谢平衡紊乱,导致不同程度的低钠血症,因临床症状多样,无特异性表现,与肿瘤引起的症状类似,易造成误诊、漏诊。在积极治疗原发肿瘤的基础上,严格限制液体摄入量是有效的治疗方法。此外,精氨酸加压素V2受体拮抗剂对SIADH所致轻、中度低钠血症有良好疗效和安全性。多数报道认为SIADH是SCLC预后不良的独立因素。

Syndrome of inappropriate secretion of antidiuretic hormone(SIADH) is a common complication of small cell lung cancer(SCLC).Recent studies have suggested that the origin of this disease is related to increased secretion of ADH by tumor cells and application of some chemotherapy drugs.The SIADH can lead to metabolism disturbance of water and sodium,resulting in varying degrees of hyponatremia.Due to the atypical symptoms,the diagnosis is difficult.More cases are misdiagnosed or missed diagnosed.The primary tumor must be treated and the restriction of fluid intake is the main and effective method to deal with SIADH.In addition,Arginine vasopressin V2 receptor antagonists have good efficacy and safety on mild and moderate hyponatremia caused by SIADH.Prognosis of SCLC patients with SIADH is poor in most reports,and SIADH is the independent factor.