住院患者复杂性血钠异常的认识和预后

Understanding and prognosis of complex dysnatremia in hospitalized patients

血钠异常包括低钠血症和高钠血症,在住院患者中普遍存在。血钠异常的临床表现主要受血钠异常的类型、严重程度和发展速度影响。但任何血钠异常均与住院患者不良结局风险增加相关。即使轻度的血钠异常、甚至是血钠正常范围内的临界升高或降低,均可能增加不良结局的风险。短时间内出现低钠血症和高钠血症称为混合性血钠异常,可能存在更高的死亡风险。血钠波动指血钠在一段时间内的变化程度,越来越多的证据表明,血钠波动较大与不良结局风险增加密切相关。由于血钠波动不取决于某一具体的血钠检测值,因此适用于判断住院患者复杂性血钠异常的预后,为住院患者不良结局的监测和预警提供更多依据。总之,住院患者复杂性血钠异常有待进行更深入的研究,以加强对血钠异常的管理,最大程度地减少不良结局的发生。

Dysnatremias,including hyponatremia and hypernatremia,are prevalent in hospitalized patients.The clinical presentation of dysnatremia is largely influenced by the type,severity,and rate of progression of dysnatremias.However,any dysnatremia is associated with an increased risk of poor outcomes in hospitalized patients.Even mild dysnatremia,or even slight elevation or decrease within the normal range of serum sodium,may increase the risk of poor outcomes.The presence of hyponatremia and hypernatremia over a short period of time is called a mixed dysnatremia,which may increase the risk of mortality.Serum sodium fluctuation refers to the degree of change in serum sodium over a period of time.The growing evidence has shown that greater serum sodium fluctuations are associated with an increased risk of poor outcomes.Serum sodium fluctuation does not depend on a specific serum sodium,so it is suitable for determining the prognosis of complex dysnatremia in hospitalized patients,providing more clues for monitoring and early warning of adverse outcomes in hospitalized patients.In conclusion,complex dysnatremia in hospitalized patients requires more studies to enhance the management of dysnatremia and minimize the occurrence of poor outcomes.