以低钠血症为首发症状的肺癌诊疗分析及文献复习  

Diagnosis and Treatment of Lung Cancer with Hyponatremia as the First Symptom and Literature Review

作　　者：钟敏 张爱敏 孙启天 刘晓燕[2] 王爱辉[3] 高宇[2] ZHONG Min;ZHANG Ai-min;SUN Qi-tian;LIU Xiao-yan;WANG Ai-hui;GAO Yu(Graduate School of Chengde Medical University,Chengde,Hebei,067000,China;Department of Endocrinology,Affi liated Hospital of Chengde Medical University,Chengde,Hebei,067000,China;Department of Nuclear Medicine,Affi liated Hospital of Chengde Medical University,Chengde,Hebei,067000,China)

机构地区：[1]承德医学院研究生院,河北承德067000 [2]承德医学院附属医院内分泌科 [3]承德医学院附属医院核医学科

出　　处：《承德医学院学报》2021年第6期475-478,共4页Journal of Chengde Medical University

摘　　要：目的探讨以低钠血症为首发症状的肺癌患者的诊疗过程、临床表现及转归。方法对4例低钠血症患者进行回顾性分析。结果4例肺癌患者均以血钠低首诊,血钠在112~122mmol/L之间,血浆渗透压低,尿渗透压高,诊断SIADH,给予限水、补钠治疗可明显改善低钠血症。经随访,积极治疗原发病后3例肺癌患者病情稳定,1例患者死亡。结论肺癌所致的SIADH临床表现为低钠血症,此为肺癌诊断提供了线索,该病发病隐匿,如及早发现和积极治疗有利于改善患者预后。Objective To explore the diagnosis and treatment process,clinical manifestation and outcome of lung cancer patients with hyponatremia as the fi rst symptom.Methods Retrospective analysis of 4 patients with hyponatremia.Results Four patients with lung cancer were fi rst diagnosed with hyponatremia,their serum sodium was between 112~122mmol/L,and their plasma osmotic pressure was low and urine osmotic pressure was high,so they were diagnosed as SIADH.The treatment of water restriction and sodium supplement can signifi cantly increase the concentration of serum sodium.Through follow-up,we know that 3 patients with primary disease are in stable condition after active treatment,but the other one patient has died.Conclusion The clinical manifestation of SIADH,caused by lung cancer is hyponatremia.This provides clues for the diagnosis of lung cancer.However,the incidence of the disease is hidden,if early detection and active treatment will help to improve the prognosis of patients.

关 键 词：低钠血症 肺癌 抗利尿激素不适当分泌综合症 

分 类 号：R734.2[医药卫生—肿瘤]