癌症患者低钠血症治疗研究进展

Progress of hyponatremia treatment in cancer patients

低钠血症是目前癌症患者中最常见的电解质紊乱症状,其发病机制与抗利尿激素分泌失调综合征（SIADH）密切相关.低钠血症极少危及患者生命,但会延长住院时间、推迟化疗计划、降低疗效,对患者的生命质量及预后造成不良影响.临床上根据其症状的严重程度和发生时间选择最佳的治疗方案.高渗氯化钠溶液适用于SIADH引起的急性症状性低钠血症患者,而慢性无症状性低钠血症则首选液体限制进行纠正.当液体限制不能达到治疗目的时,则需要考虑选择药物治疗.文章分析了当前国际指南中对于低钠血症的治疗研究进展,并对目前治疗方案中存在的问题和未来的研究前景进行综述.

Hyponatremia is the most common electrolyte abnormality in cancer patients, which is usually related to the syndromes of inappropriate antidiuretic hormone secretion （SIADH）. Despite not frequent life-threatening, it mostly causes prolonged hospitalization, delaying in scheduled chemotherapy, reducing of the efficacy, worsening of patients＇ prognosis and quality of life. The optimal treatment strategy should be chosen based on the severity and the onset time of the symptoms in clinic. Hypertonic saline solution is appropriate for acute, symptomatic patients with hyponatremia caused by SIADH, nevertheless fluid restriction is advised to chronic symptomless hyponatremia which recommends correcting at a slower rate. When fluid restriction is limited, pharmacological therapy should be a necessary choice. This review summarizes the recent progress of hyponatremia in international guidelines and discusses the defect of hyponatremia managements and the research prospect in the future.