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化疗相关性低钠血症病因分析与治疗 预览

Diagnosis and Treatment of Chemotherapy-associated Hyponatremia
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摘要 目的 探讨化疗药物导致低钠血症的病因,建立有效防治措施。方法 分析1例使用多柔比星联合环磷酰胺方案化疗患者化疗后出现药物不良反应的临床资料,探讨病因、诊治及不良反应的关系,提出治疗建议。结果 环磷酰胺是多柔比星联合环磷酰胺方案化疗后出现急性严重低渗性低钠血症的主要致病因素,低渗性低钠血症的发生可能与抗利尿激素分泌异常综合征相关。结论 化疗药物可导致低钠血症的临床风险高,发病初期隐匿性强,发生机制不尽相同,需遵循科学有效的判断,及时有效地处理。 Objective To determine the etiology of hyponatremia induced by chemotherapy,and to establish effective prevention as well as treatment measures.Methods We analyzed the clinical data of adverse drug reactions following chemotherapy in patients treated with doxorubicin combined with cyclophosphamide.We also assessed the relationship between etiology,diagnosis,treatment,adverse reactions,and proposed treatment recommendations.Results Cyclophosphamide was the main pathogenic factor in acute severe hypoosmotic hyponatremia following chemotherapy with doxorubicin combined with cyclophosphamide.Hypoosmotic hyponatremia may be related to the mechanism of abnormal antidiuretic hormone secretion.Severe acute hypotonic hyponatraemia can be induced by cyclophosphamide following chemotherapy with AC.The mechanism of cyclophosphamide-induced hyponatremia was related to inappropriate antidiuretic hormone secretion.Conclusion Chemotherapeutic drugs can lead to hyponatremia with high clinical risk,is occult during early onset and involves different mechanisms,which require further investigation for early diagnosis and timely efficient treatments.
作者 王怀冲 宋晓坤 WANG Huaichong;SONG Xiaokun(Department of Pharmacy,Integrated Chinese and Western Medicine Hospital of Zhengjiang Province,Hangzhou 310003,China;Department of Pharmacy,Tianjin Medical University Cancer Institute and Hospital,Tianjin 300201,China)
出处 《中国全科医学》 北大核心 2018年第33期4138-4143,共6页 Chinese General Practice
基金 浙江省医药卫生科技计划项目(2015KYB309)。
关键词 意识障碍 低钠血症 药物疗法 联合 ADH分泌不当综合征 Consciousness disorders Hyponatremia Drug therapy,combination Inappropriate ADH syndrome
作者简介 通信作者:宋晓坤,主任药师;E-mail:xiaokun18@hotmail.com。
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