低钠血症398例临床特征分析

Retrospective cohort study of hyponatremia in hospitalized patients

目的分析低钠血症的病因、转归及特点,为本地低钠血症的临床流行病学研究提供初步资料。方法收集2012年6月—2013年12月于大连医科大学附属第一医院住院的低钠血症患者临床资料,按照血清钠离子(Na+)浓度分为轻度低钠血症组(130≤Na+<135 mmol/L),中度低钠血症组(120≤Na+<130 mmol/L)以及重度低钠血症组(Na+<120 mmol/L),分析病因、各组转归、合并症情况及血钠水平的影响因素等。结果 398例低钠血症在住院患者中的发病率0.03%,根据基础疾病进行分析,其中以肺部疾病103例(占25.88%),中枢神经系统疾病74例(占18.59%),恶性肿瘤56例(占14.07%),消化系统疾病53例(占13.32%)居多。重度组死亡率高于轻、中度组(P<0.05)。年龄、肾小球滤过率与血Na+呈负相关;血Cl-、血渗透压与血Na+呈正相关,差异有显著性意义(P<0.05)。结论低钠血症是住院患者常见的并发症,主要原因是肺部疾病、中枢神经系统疾病、恶性肿瘤;随着年龄增长、肾小球滤过率升高时容易合并低钠血症。早期识别、正确处理能降低低钠血症的发生率和病死率。

Objective To retrospectively analyze the causes,outcomes and characteristics of hyponatremia and to provide preliminary reference for clinical epidemiological study of hyponatremia in the local area. Methods Clinical data of inpatients with hyponatremia were collected. Etiologies and outcomes of hyponatremia were summarized. Results The incidence of hyponatremia was 0. 03% in the 398 inpatients,who were hospitalized by lung diseases（ 25. 88%）,central nervous system diseases（ 18. 59%） or malignant tumor（ 14. 07%）. The mortality rate in the severe hyponatremia group was higher than the mild and moderate groups. Age and glomerular filtration rate were negatively correlated with blood sodium level;whereas blood chloride and osmotic pressure were positively correlated. Conclusion Hyponatremia is a common complication in hospitalized patients with lung diseases,central nervous system diseases or malignant tumor. Patients with older age and higher glomerular filtration rate are more vulnerable for hyponatremia. Early recognition and appropriate treatment can reduce the morbidity and mortality of hyponatremia.