以低钠血症为首发症状的老年感染性疾病1例并文献复习
摘要
<正>老年性低钠血症是指65岁及以上病人血清钠浓度<135 mmol/L。目前公认低钠血症有轻、中、重三型,轻度是指血清钠为130～135 mmol/L,中度是指血清钠为125～130 mmol/L,重度是指血清钠<125 mmol/L[1]。在老年危重病人中,低钠血症往往是病情加重及死亡的主要因素,因此当老年病人出现低钠血症时,及时纠正低钠血症就是挽救老年病人的生命。老年病人因身体功能减退,机体反应性较差,很多老年性疾病被诊断前往往都表现为不典型的症状、体征以及检查结果异常。本文通过1例以低钠血症为主要表现的老年感染病例来探讨低钠血症的病因、发病机制及治疗
引文
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[6]常俊玲.30例老年重症肺炎并低钠血症的临床治疗体会[J].中国医药指南,2013,11(20):546-547.
[7]Furst H,Hallows KR,Post J,et al.The urine/plasma electrolyteratio:a predictive guide to water restriction[J].Am J Med Sci,2000,319(4):240-244.
[8]Grant P,Ayuk J,Bouloux PM,et al.The diagnosis and management of inpatient hyponatraemia and SIADH[J].Eur J Clin Invest,2015,45(8):888-894.
[9]Lee J J,Kilonzo K,Nistico A,et al.Management of hyponatremia[J].CMAJ,2014,186(8):E281-E286.
[10]Trueman D,Robinson P,Dale P,et al.The costeffectiveness of tolvaptan for the treatment of hyponatraemia secondary to syndrome of inappropriate antidiuretic hormone secretion in Sweden[J].Value Health,2014,17(7):A350.
[11]Goldsmith SR.Treatment options for hyponatremia in heart failure[J].Congest Heart Fail,2010,16(Suppl 1):S15-S18.
[2]刘慧敏,李明龙.低钠血症诊疗研究进展[J].中华老年多器官疾病杂志,2018,17(3):233-236.
[3]Schuetz P,Haubitz S,Christ-Crain M,et al.Hyponatremia and anti-diuretic hormone in Legionnaires'disease[J].BMCInfect Dis,2013,11(13):585.
[4]戴国欣.老年重症肺炎合并低钠血症临床诊治的研究进展[J].医学信息,2018,31(1):4-6.
[5]姚鸣华.电解质紊乱对老年重症肺炎患者预后的影响[J].实用老年医学,2014,28(4):294-295,298.
[6]常俊玲.30例老年重症肺炎并低钠血症的临床治疗体会[J].中国医药指南,2013,11(20):546-547.
[7]Furst H,Hallows KR,Post J,et al.The urine/plasma electrolyteratio:a predictive guide to water restriction[J].Am J Med Sci,2000,319(4):240-244.
[8]Grant P,Ayuk J,Bouloux PM,et al.The diagnosis and management of inpatient hyponatraemia and SIADH[J].Eur J Clin Invest,2015,45(8):888-894.
[9]Lee J J,Kilonzo K,Nistico A,et al.Management of hyponatremia[J].CMAJ,2014,186(8):E281-E286.
[10]Trueman D,Robinson P,Dale P,et al.The costeffectiveness of tolvaptan for the treatment of hyponatraemia secondary to syndrome of inappropriate antidiuretic hormone secretion in Sweden[J].Value Health,2014,17(7):A350.
[11]Goldsmith SR.Treatment options for hyponatremia in heart failure[J].Congest Heart Fail,2010,16(Suppl 1):S15-S18.