【摘要】：目的:提高臨床醫(yī)師對(duì)隱性中樞性尿崩癥的認(rèn)識(shí)。方法:對(duì)3例腺垂體功能減退使用糖皮質(zhì)激素后出現(xiàn)尿崩癥的患者進(jìn)行病例分析,同時(shí)查詢中國知網(wǎng)、維普以及Pub Med等中英文數(shù)據(jù)庫,找到相關(guān)病例,總結(jié)其臨床特點(diǎn)。結(jié)果:3例患者均存在HPA軸、甲狀腺軸以及性腺軸功能減退,給予糖皮質(zhì)激素替代后,均出現(xiàn)尿量、血鈉、血氯、血滲透壓明顯升高,尿比密明顯下降,其中2例完成禁水加壓素試驗(yàn),尿滲透壓較推藥前上升超過9%,另1例給予醋酸去氨加壓素后尿量明顯減少。同時(shí),通過文獻(xiàn)檢索發(fā)現(xiàn)了9篇相關(guān)病例報(bào)道,并就各自臨床特點(diǎn)進(jìn)行了匯總。結(jié)論:隱性中樞性尿崩癥在臨床上較為罕見,典型癥狀因?yàn)樘瞧べ|(zhì)激素缺乏而被隱藏,當(dāng)腺垂體功能減退患者在給予糖皮質(zhì)激素治療后若出現(xiàn)明顯多尿以及低比重尿時(shí),應(yīng)考慮合并中樞性尿崩癥。
[Abstract]:Objective: to improve clinicians' understanding of occult central diabetes insipidus. Methods: the cases of diabetes insipidus after the use of glucocorticoid in 3 patients with hypophysis were analyzed. At the same time, the Chinese knowledge network, Weipu and Pub Med were queried to find the relevant cases and summarize their clinical characteristics. Results: the function of HPA axis, thyroid axis and gonadal axis decreased in all 3 patients. after glucocorticoid replacement, urine volume, blood sodium, blood chlorine, blood osmotic pressure and urine specific density decreased significantly. Among them, 2 cases completed water-free vasopressin test, urine osmotic pressure increased by more than 9% compared with that before administration, and urine volume decreased significantly after administration of deaminopressin acetate. At the same time, 9 related case reports were found through literature retrieval, and their clinical characteristics were summarized. Conclusion: occult central diabetes insipidus is rare in clinic, and the typical symptoms are hidden because of glucocorticoid deficiency. When patients with hypophysis have obvious polyuria and low specific gravity urine after glucocorticoid treatment, central diabetes insipidus should be considered.
【作者單位】： 重慶醫(yī)科大學(xué)附屬第一醫(yī)院內(nèi)分泌內(nèi)科;
【基金】：國家臨床重點(diǎn)�？平ㄔO(shè)資助項(xiàng)目(編號(hào):財(cái)社[2011]170號(hào))
【分類號(hào)】：R584.3

【相似文獻(xiàn)】

相關(guān)期刊論文 前10條

1 陳衛(wèi)文;孔垂根;;中樞性尿崩癥69例臨床分析[J];臨床內(nèi)科雜志;2006年08期

2 蔣翠萍;顧芹;孫皎;尤傳一;;中樞性尿崩癥臨床分析及治療(附17例報(bào)告)[J];上海醫(yī)學(xué);2008年11期

3 王偉莉;于志剛;;遺傳性中樞性尿崩癥合并肺結(jié)核一例[J];中國優(yōu)生與遺傳雜志;2008年04期

4 劉美蓮;中樞性尿崩癥23例臨床分析[J];廣西醫(yī)科大學(xué)學(xué)報(bào);1996年02期

5 盧榮清;小兒中樞性尿崩癥80例分析[J];廣西醫(yī)學(xué);1997年04期

6 鄭寧英;中樞性尿崩癥患者的骨受損[J];國外醫(yī)學(xué)(內(nèi)分泌學(xué)分冊(cè));1999年05期

7 顧鋒,金自孟,張殿喜,鄧潔英,史軼蘩;中樞性尿崩癥408例的病因及臨床特點(diǎn)分析[J];中華醫(yī)學(xué)雜志;2001年19期

8 李昌臣;中樞性尿崩癥與替代療法[J];遼寧醫(yī)學(xué)雜志;2001年01期

9 陳月平;中樞性尿崩癥72例臨床分析[J];皖南醫(yī)學(xué)院學(xué)報(bào);2002年01期

10 孫洪濤,郭志軍,郭義茹;遺傳性中樞性尿崩癥一家系八例[J];中華醫(yī)學(xué)遺傳學(xué)雜志;2002年06期

相關(guān)會(huì)議論文 前5條

1 王先令;母義明;;謹(jǐn)慎診斷特發(fā)性中樞性尿崩癥[A];中華醫(yī)學(xué)會(huì)第十一次全國內(nèi)分泌學(xué)學(xué)術(shù)會(huì)議論文匯編[C];2012年

2 侯文芳;田R，

本文編號(hào)：2516539