垂体后叶素治疗咯血致低钠血症115例临床分析

Hypophysin-induced hyponatremia in 115 cases of patients with hemoptysis

目的了解垂体后叶素治疗咯血时低钠血症及相关的神经系统症状的发生情况。方法回顾性分析115例经垂体后叶素治疗的咯血患者的临床资料。结果使用垂体后叶素后平均血钠水平下降5.9mmol/L(P=6.298×10-21),47例(40.8%)发生低钠血症。垂体后叶素使用较多者发生低钠血症的几率较高(P=0.050)。低钠血症常见的神经系统症状为头昏、头痛、感觉迟钝和淡漠,严重的昏迷少见,发生于极低的低钠血症患者及血钠纠正过快者。出现抽搐的患者伴有低钙血症。结论垂体后叶素治疗咯血可能引起血钠水平减少,且与剂量呈正相关。低钠血症合并的神经系统症状多数轻微,个别极低血钠者可能出现严重的症状。不能确定抽搐是否与低钠血症有关。

Objective The aim of this study was to identify the hyponatremia and its related syndrome of nerve system in hemoptysis patients treated with hypophysin.Methods Clinical data of 115 patients with hemopthysis treated by hypophysin was studied retrospectively.Results Among the 115 cases, 47 .（40.8% ） suffered from hyponatremia, and the mean concentration of serum sodium decreased 5.9mmol/L after the treatment. It is suggested that patients with higher dose of hypophysin are more likely to suffer from hyponatremia （P〈0.05）. Dizziness, headache, dysesthesia and apathy were common in patients with hyponatremia, whereas comma was seldom seen, which occurred only in severe hyponatremia.Those presented with convulsion also had hypocalcemia.Conclusion Hypophysin might induced dose-dependent hyponatremia in patients with hemopthysis. Most symptoms associated with hyponatremia were mild,however, a few patients with severe hyponatremia manifested with serious symptom.h was not confirmed whether the hyponatremia was attributed to convulsion.