肺癌合并抗利尿激素分泌不当综合症6例临床分析

Syndrome of inappropriate anti-diuretic hormone in lung-cancer patients: six cases

目的:研究肺癌合并抗利尿激素分泌不当综合症(syndrome of inappropriate antidiuretic hormone secretion,SIADH)引起的低钠血症的临床特点、治疗方法及对评价预后的价值。方法:回顾分析大庆油田总医院2010年6月至2013年12月收治6例肺癌合并SIADH的临床资料,其中小细胞肺癌4例、腺癌1例、鳞癌1例。结果:对于不同血钠水平的患者给予不同的治疗方案,患者的乏力、神经系统等症状及血钠、尿钠、血浆渗透压均得到改善。结论:部分肺癌患者出现SIADH引起的低钠血症,出现电解质紊乱提示预后差、死亡率高,并因临床重视不够而出现延误治疗的情况。对于确诊的患者给予适当的治疗后,不论是临床症状还是血钠水平均可获得明显改善。

Objective：To investigate the clinical characteristics, treatment, and evaluation of the prognosis of syndrome of inap-propriate anti-diuretic hormone （SIADH） in lung-cancer patients. Methods：We review the clinical data of six lung cancer cases, includ-ing four small cell lung cancer, one adenocarcinoma, and one squamous cell carcinoma, with SIADH complication. All six cases were treated in our hospital over the past three years. Results：Patients with various serum sodium levels were provided different therapeutic regimens. Symptoms of fatigue and nervous system disorders, plasma sodium, urine sodium, and plasma osmotic pressure were alleviat-ed. Conclusion：SIADH is a common complication of lung cancer, particularly in small lung cancer cases. Electrolyte disturbances indi-cate poor prognosis, high mortality rate, and delay in treatment because of clinical interest. After a final diagnosis has been made and ap-propriate treatment has been administered, clinical symptoms were relieved and blood sodium levels were quickly and significantly im-proved in these patients.