摘要
导致 Thiazide 的 hyponatremia 是在老个人的减少的钠层次的主要原因之一。这评论关于联系 thiazide 的 hyponatremia 介绍当前的证据。联系 Thiazide 的 hyponatremia 与象收到 thiazides 的大剂量的那些那样的某些风险因素主要在病人被观察，有许多 comorbidity，例如心失败，肝疾病或恶意，并且拿几药，例如 non-steroidal 反煽动性的药，选择血清素重新举起禁止者或 tricyclic 抗抑郁剂。钠集中应该为开发联系 thiazide 的 hyponatremia 与风险因素在病人被监视，临床医生们应该即时与显示减少的钠层次的神经符号在病人测量浆液钠层次。有联系 thiazide 的 hyponatremia 的病人的临床、生物化学的侧面可以是细胞外的体积弄空或不恰当的尿分泌抑制剂荷尔蒙分泌物(SIADH ) 的症候群的。可能的联系 thiazide 的 hyponatremia 的调查由于 thiazides (弄空相关的细胞外的体积或象 SIADH 一样) 包括减少的钠层次的另外的原因和 hyponatremia 的特征的鉴定的排除。治疗应该小心地被监视由于 overcorrection 避免严肃的神经复杂并发症。临床医生们应该阻止与联系利尿剂的 hyponatremia 的历史在病人规定 thiazides 并且应该为开发联系 thiazide 的 hyponatremia 与风险因素在病人比较喜欢 thiazides 的低剂量。
Thiazide-induced hyponatremia is one of the main causes of decreased sodium levels in elderly individuals. This review presents the current evidence regarding the thiazide-associated hyponatremia. Thiazide-associated hyponatremia is observed mainly in patients with certain risk factors such as those receiving large doses of thiazides, having much comorbidity, such as heart failure, liver disease or malignancy, and taking several medications, such as non-steroidal anti-inflammatory drugs, selective serotonin re-uptake inhibitors or tricyclic antide- pressants. Sodium concentration should be monitored in patients with risk factors for developing thiazide-associated hyponatremia and clini- cians should measure promptly serum sodium levels in patients with neurologic signs indicating reduced sodium levels. The clinical and biochemical profile of patients with thiazide-associated hyponatremia may be that of extracellular volume depletion or the syndrome of inap- propriate antidiuretic hormone secretion （SIADH）. The investigation of possible thiazide-associated hyponatremia includes the exclusion of other causes of decreased sodium levels and the identification of the characteristics of hyponatremia due to thiazides （extracellular volume depletion-related or SIADH-like）. Treatment should be carefully monitored to avoid serious neurologic complications due to overcorrection. Clinicians should discourage prescribing thiazides in patients with a history of diuretic-associated hyponatremia and should prefer low doses of thiazides in patients with risk factors for developing thiazide-associated hyponatremia.
