多器官功能衰竭中肾衰的少见症—尿崩

Diabetes insipidus-rarely symptom of renal failure on multiple organs failure

目的 报道因多器官功能衰竭 (MOF)产生尿崩症状的病例。方法 MOF 14例 ,在病因治疗和程序化脏器支持的同时 ,监测其尿量、血、尿晶体渗透量、血电解质、血气分析等指标 ,观察使用垂体后叶素前、后的变化。结果 2例治愈 ,12例死亡。病程第 2～ 9d出现尿崩症状 ,持续时间为 43± 2 2h( x±s,n =14) ,高峰尿量 975 3± 2 46 1ml/d( x±s,n =14) ,并有排出等渗尿、血电解质浓度升高、酸血症等变化。垂体后叶素静滴 (1U/h)后 ,3例尿量减少 ,8例 2～ 4h尿量减少 ,3例无效。

Objective To report diabetes insipidus cases caused by multiple organs failure(MOF).Methods 14 cases suffered from MOF,etiological treatment and programmatic organ supporting were performed.Urine volume,crystal osmotic pressure of blood and urine,free water clean rate,blood electrolyte,blood gas analysis etc.were monitored.Their changes before and after pituitrin infusion were observed.Results 2 cases were cured,12 cases died.Diabetes insipidus was appeared from 2ed to 9th day of course and its time was maintained on 43±22 hours ( ±s ,n=14),peak urine volume was reached 9 753±2 461 ml/d( ±s ,n=14).At same time,isotonic urine discharged,electrolytic concentration of blood rised and acidemia happened could be seen.When pituitrin was infused by 1U/h dosage,urine volume decreased in 3 cases,8 cases decreased in short time(2～4 h)and 3 cases were no reaction.Conclusions Diabetes insipidus caused by MOF was the result of renal concentrative function failure. [