高钠血症作为神经重症疾病的生物标记物研究进展

Research Progress of Hypernatremia as a Biomarker of Severe Neurological Diseases

神经重症患者常常并发高钠血症,其几率远远高于普通住院患者,提示两者间存在相关性。合并高钠血症的神经重症患者,预后较差,死亡率更高,提示高钠血症有可能是神经重症疾病的生物标记物。高钠血症在神经重症患者中又有其特殊性。其可通过影响下丘脑垂体分泌功能、损伤下丘脑渗透压感受器、使用高渗性治疗、体温调节异常等多种中枢机制引起。理解其发病机制对高钠血症的诊断及治疗至关重要。本文详细介绍了神经重症患者并发高钠血症的中枢性机制、临床表现、治疗及预后,以揭示高钠血症作为神经重症疾病生物标记物的可能性。

Hypernatremia often occurs in patients with severe neurological disease, and its probability is much higher than that of ordinary hospitalized patients, suggesting that there is a correlation be-tween the two. The prognosis of neurocritical patients with hypernatremia is poor and the mortality is higher, suggesting that hypernatremia may be a biomarker of neurocritical diseases. Hyper-natremia has its particularity in patients with severe neurological disease. It can be caused by a va-riety of central mechanisms, such as affecting hypothalamic pituitary secretion function, damaging hypothalamic osmoreceptors, using hypertonic therapy, and abnormal temperature regulation. Understanding its pathogenesis is essential for the diagnosis and treatment of hypernatremia. This article introduces the central mechanism, clinical manifestations, treatment and prognosis of hy-pernatremia in patients with severe neurological disease in detail, in order to reveal the possibility of hypernatremia as a biomarker of severe neurological disease.