老年人抗利尿激素异常分泌综合征的临床特点  

CLINICAL CHARACTERISTICS OF SYNDROME OF INAPPROP RIATE ANTIDIURETIC HORMONE SECRETION IN THE ELDERLY

作　　者：顾芹[1] 尤传一[1] 顾同进[2] 李文贤[3] 庞仲华[4] 朱惠莉[4] 

机构地区：[1]华东医院内分泌科,上海市200040 [2]华东医院消化科,上海市200040 [3]华东医院神经内科,上海市200040 [4]华东医院呼吸科,上海市200040

出　　处：《老年医学与保健》2001年第2期97-99,共3页Geriatrics & Health Care

摘　　要：目的 探讨老年人抗利尿激素异常分泌综合征 (SIADH)的临床特点。 方法 对我院 1982年 2月至 2000年 6月住院患者中，资料较全 30例老年人 SIADH，进行回顾性临床分析。 结果 原发病中肺部疾病 16例 (53％ )，中枢神经系统疾病 11例 (37％ )，肿瘤 2例 (10％ )；临床症状中神经系统表现 76.7％，消化道症状 43.7％；血清钠 102～ 128mmol/L，血渗透压 220～ 272mmol/L,尿渗透压 368～ 784mmol/L,血尿酸 0.13～ 0.29mmol/L； 8例患者死亡，均与严重原发病有关。 结论 老年人 SIADH临床特征： 1)老年人易发生 SIADH； 2)原发疾病以肺部疾病最多见； 3)诱因为补液过多； 4)临床表现以神经系统及消化系统症状为主； 5)常伴低尿酸血症； 6)治疗限水比补钠更为重要。Objective To investigate the clinical characteristics of Syndrome of Inappropriate Antidiuretic Hormone Secretion(SIADH) in the elderly. Methods Among the in－ patients from February 1982 to June 2000 in our hospital,the clinical data of thirty senile SIADH cases were analyzed retrospectively. Results Among them,sixteen patients were diagnosed as pulmonary diseases(53％ ),eleven patients were central nervous diseases(37％ )and two patients were diagnosed as tumor.As for the clinical symptoms,76.7％ of them revealed as nervous system abnormality and 43.7％ of them showed the symptom of gastro－ intestinal tract.The serum sodium concentration was between 102 and 128 mmol/L,blood osmotic pressure from 220 to 272 mmol/L,uric osmotic pressure from 368 to 784 mmol/L,and the concentration of uric acid was between 0.13 and 0.29 mmol/L.Among the thirty patients,eight of them died and all the death were resulted from the severity of their original diseases. Conclusions Some clinical characteristics of senile SIADH in this paper are:1)The incidence of SIADH was relativerly high in the senile patients;2)Pulmonary diseases consisted most of the original diseases;3)Large infusion was the main remote cause;4)Symptoms of the nervous system and the intestinal tract were showed in most of the clinical demonstration; 5)Low uric acid concentration was very common; 6)As for the treatment,restriction of water intake was more important than the supplement of sodium.

关 键 词：抗利尿激素异常分泌综合征 老年人 SIADH 原发病 临床症状 治疗 

分 类 号：R442.8[医药卫生—诊断学]