Research progress in the management of hyponatremia in cirrhosis.

Abstract

Abstract:

Abstract：Hyponatremia in liver cirrhosis is defined by a serum sodium concentration of less than 130 mmol/L，but some scholars think that the definition is too strict and serum sodium concentration should be less than 135 mmol/L.Hyponatremia in liver cirrhosis is characterized by excessive renal retention of water relative to sodium due to reduced solute-free water clearance.The primary cause is increased release of arginine vasopressin.As clinical hyponatremia is usually difficult to treat，the occurrence of vanptans，particullarlly tolvaptan，a highly selective arginine vasopressin V2 receptor antagonist on hyponatremia cirrhosis is of importance in clinical practice.A number of studies have suggested short-term，few of them even with long-term，application tolvaptan is safe and effective，and it is currently the sole vanptan to be used in clinical hyponatremia in patients with cirrhosis.

Key words: cirrhosis, hyponatremia, tolvaptan, acute kidney injury, hepatic encephalopathy, arginine vasopressin

摘要：

肝硬化低钠血症是指血清钠浓度＜130 mmol/L，但也有学者认为该定义过于严格，应当放宽为＜135 mmol/L。其最重要的病理生理特征性改变是精氨酸加压素(AVP)的分泌增加，使肾脏清除无溶质水的能力受损，导致水、钠潴留。鉴于低钠血症临床处理困难，高度选择性精氨酸加压素V2受体拮抗剂普坦药物的发现，特别是托伐普坦的上市，对肝硬化低钠血症产生了良好的临床治疗效果。大量研究表明，短期甚至长期应用托伐普坦是安全有效的，且其是目前惟一可以用于临床肝硬化低钠血症的普坦类药物。

关键词: 肝硬化, 低钠血症, 托伐普坦, 急性肾损伤, 肝性脑病, 精氨酸加压素

CLC Number:

R575.2

WANG Yu-ming.. Research progress in the management of hyponatremia in cirrhosis.[J]. Acta Metallurgica Sinica.

王宇明. 肝硬化合并低钠血症的处理[J]. 中国实用内科杂志.

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