初诊表现为低钠血症的肺癌27例临床特点分析

Analysis of patients with lung cancer and hyponatremia

目的分析初诊表现为低钠血症的肺癌患者临床特点,探讨其低钠血症的原因。方法回顾性分析2008—2009年北京协和医院初诊表现为低钠血症的27例肺癌患者临床特点,并按照血钠水平将其分为相对高钠组和相对低钠组,分析其特点。结果本组患者低钠原因考虑为抗利尿激素不适当分泌综合征(SIADH)。40.7%的患者病理诊断小细胞肺癌。与相对高钠组相比,相对低钠组患者吸烟比例(92.8%对61.5%)和小细胞肺癌比例(64.3%对15.4%)较高,且脑转移患者比例有增高趋势。单纯化疗能使53.3%的患者血钠恢复正常。结论小细胞肺癌是肺癌患者低钠血症的主要原因。肺癌脑转移患者低钠血症的发生率也有增高趋势,常规化疗对纠正患者血钠疗效不佳。

Objective This retrospective analysis was to elucidate the clinical characteristics of patients with lung cancer and hyponatremia. Methods We analyzed the clinical data from 27 patients with lung cancer who were treated at Peking Union Medical College Hospital between 2008 and 2009. The patients were divided into two groups according to the level of serum sodium. Results The reason of hyponatremia was Syndrome of inappropri- ate secretion of antidiuretic hormone （SIADH）. 41% of patients were diagnosed as small cell lung cancer. Com- pared with High level group,the Low level group had higher ratio of smoker（92. 8% vs 61.5% ） and small cell lung cancer（64. 3% vs 15.4% ）. There was a trend of the higher ratio of brain metastasis in Low level group. Chemotherapy could correct the serum sodium in 53.3% of the patients. Conclusion The data suggests that small cell lung cancer is the most important reason in the patients who suffered from lung cancer and hyponatremia. Brain metastasis may make the serum sodium level be lower. Chemotherapy shows limit effect in correct the serum sodium.