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中华肺部疾病杂志(电子版) ›› 2024, Vol. 17 ›› Issue (02) : 313 -315. doi: 10.3877/cma.j.issn.1674-6902.2024.02.032

短篇论著

AECOPD低钠血症发生风险及预测因素分析
周文欢1, 杨黎2,()   
  1. 1. 610081 成都,四川省建筑医院呼吸与危重症医学科
    2. 610500 成都,四川养老与老年健康协同创新中心;610500 成都,成都医学院第一附属医院呼吸与危重医学科
  • 收稿日期:2023-10-09 出版日期:2024-04-25
  • 通信作者: 杨黎
  • 基金资助:
    2022年度四川养老与老年健康协同创新中心联合(32)

Risk and predictors of hyponatremia in the acute exacerbation of chronic obstructive pulmonary disease

Wenhuan Zhou, Li Yang()   

  • Received:2023-10-09 Published:2024-04-25
  • Corresponding author: Li Yang
引用本文:

周文欢, 杨黎. AECOPD低钠血症发生风险及预测因素分析[J]. 中华肺部疾病杂志(电子版), 2024, 17(02): 313-315.

Wenhuan Zhou, Li Yang. Risk and predictors of hyponatremia in the acute exacerbation of chronic obstructive pulmonary disease[J]. Chinese Journal of Lung Diseases(Electronic Edition), 2024, 17(02): 313-315.

慢性阻塞性肺疾病急性加重期(acute exacerbation of chronic obstructive pulmonary disease, AECOPD)是慢性阻塞性肺疾病(chronic obstructive pulmonary disease, COPD)自然病程中的重要事件,对健康状况、住院率和疾病进展有不利影响[1,2,3,4]。代谢紊乱与AECOPD有关,以低钠血症常见[5]。低钠血症是人类有机体中常见的水电解质失衡,继发于神经系统疾病、消化系统疾病、心血管系统疾病等。社区获得性肺炎中低钠血症是复发的危险因素[6,7]。低钠血症引起的渗透压改变通过受体电位通道影响肺血管通透性,加重COPD,增加病死率。文献多报道低钠血症与COPD或AECOPD预后间的关系,对AECOPD低钠血症发生风险及预测因素报道尚少[8]。了解AECOPD低钠血症患病率和相关性因素,有助于提高认识和制定新的治疗策略。本文对我院收治的56例AECOPD患者低钠血症临床特征和预测因素进行分析,报道如下。

表1 AECOPD低钠血症发生风险单因素分析[(±s),n(%)]
表2 AECOPD低钠血症多因素Logistic回归分析
1
熊 锋,娄建丽. 慢性阻塞性肺疾病急性加重期预后的临床分析[J/CD]. 中华肺部疾病杂志(电子版), 2023, 16(4): 550-553.
2
Ritchie AI, Wedzicha JA. Definition, causes, pathogenesis, and consequences of chronic obstructive pulmonary disease exacerbations[J]. Clin Chest Med, 2020, 41(3): 421-438.
3
Sim YS, Lee JH, Lee EG, et al.COPD exacerbation-related pathogens and previous COPD treatment[J]. J Clin Med, 2022, 12(1): 111.
4
Jo YS, Han S, Lee D, et al. Development of a daily predictive model for the exacerbation of chronic obstructive pulmonary disease[J]. Sci Rep, 2023, 13(1): 18669.
5
Xiao M, Wang X, Wang H, et al. Risk factors for hyponatremia in acute exacerbation chronic obstructive pulmonary disease (AECOPD): a multicenter cross-sectional study[J]. BMC Pulm Med, 2023, 23(1): 39.
6
Potasso L, Sailer CO, Blum CA, et al. Mild to moderate hyponatremia at discharge is associated with increased risk of recurrence in patients with community-acquired pneumonia[J]. Eur J Intern Med, 2020, 75: 44-49.
7
Ni Y, Zhong H, Gu Y, et al. Clinical features, treatment, and outcome of psittacosis pneumonia: A multicenter study[J]. Open Forum Infect Dis, 2023, 10(2): 518.
8
García-Sanz MT, Martínez-Gestoso S, Calvo-Álvarez U, et al. Impact of hyponatremia on COPD exacerbation prognosis[J]. J Clin Med, 2020, 9(2): 503.
9
慢性阻塞性肺疾病急性加重(AECOPD)诊治专家组. 慢性阻塞性肺疾病急性加重(AECOPD)诊治中国专家共识(2017年更新版)[J]. 国际呼吸杂志2017, 37(14): 1041-1057.
10
张劭夫. 2014欧洲低钠血症诊疗临床实践指南解读[J]. 中国呼吸与危重监护杂志2015, 14(1): 103-106.
11
王 妍,闫 巍,柯 楠. 慢性阻塞性肺疾病前期特征、潜在诊断方法及干预策略[J]. 实用心脑肺血管病杂志2023, 31(10): 1-5.
12
Li S, Huang Q, Nan W, et al. Association between serum phosphate and in-hospital mortality of patients with AECOPD: A retrospective analysis on eICU database[J]. Heliyon, 2023, 9(9): e19748.
13
Pratt AJ, Purssell A, Zhang T, et al. Complexity in clinical diagnoses of acute exacerbation of chronic obstructive pulmonary disease[J]. BMC Pulm Med, 2023, 23(1): 298.
14
Bräunlich J, Turba K, Wirtz H. Reversibility of hypercapnia after an acute exacerbation of COPD[J]. Respiration, 2022, 101(9): 816-822.
15
Guecamburu M, Coquelin A, Rapin A, et al. Pulmonary rehabilitation after severe exacerbation of COPD: a nationwide population study[J]. Respir Res, 2023, 24(1): 102.
16
Tokgöz Akyıl F, Tural Önür S, Abalı H, et al. Hyponatremia is an independent predictor of emergency department revisits in acute exacerbation of COPD[J]. Clin Respir J, 2021, 15(10): 1063-1072.
17
王 淼,汪海娅. 老年住院患者低钠血症的临床特点[J]. 上海医药2023, 44(10): 27-30.
18
Lindner G, Herschmann S, Funk GC, et al. Sodium and potassium disorders in patients with COPD exacerbation presenting to the emergency department[J]. BMC Emerg Med, 2022, 22(1): 49.
19
张丽侠,王志芳,李 冲,等. 普通病房住院患者低钠血症及其性别、年龄特征的初步研究[J]. 临床内科杂志2018, 35(6): 412-414.
20
Ĉiauškaitē J, Gelžinienē G, Jurkevicienē G. Oxcarbazepine and hyponatremia[J]. Medicina (Kaunas), 2022, 58(5): 559.
21
Miyauchi T, Nishiwaki H, Mizukami A, et al. Hyponatremia and mortality in patients undergoing maintenance hemodialysis: Systematic review and meta-analysis[J]. Semin Dial, 2023, 36(4): 303-315.
22
吴琪茵,胡妙芬,黄雅萍,等. 探讨高血压对慢性阻塞性肺疾病急性加重患者发生低钠血症的影响[J]. 中外医疗2022, 41(28): 1-4.
23
Deep A, Behera PR, Subhankar S, et al. Serum electrolytes in patients presenting with acute exacerbation of chronic obstructive pulmonary disease (COPD) and their comparison with stable COPD patients[J]. Cureus, 2023, 15(4): e38080.
24
Che L, Song W, Zhang Y, et al. A randomized, double-blind clinical trial to evaluate the blood pressure lowing effect of low-sodium salt substitution on middle-aged and elderly hypertensive patients with different plasma renin concentrations[J]. J Clin Hypertens (Greenwich), 2022, 24(2): 140-147.
25
Sun Y, Wang H, Liang H, et al. A Method for estimating 24-hour urinary sodium excretion by casual urine specimen in Chinese hypertensive patients[J]. Am J Hypertens, 2021, 34(7): 718-728.
26
Knightly R, Milan SJ, Hughes R, et al. Inhaled magnesium sulfate in the treatment of acute asthma[J]. Cochrane Database Syst Rev, 2017, 11(11): CD003898.
27
Jahanian F, Khatir IG, Ahidashti HA, et al. The effect of intravenous magnesium sulphate as an adjuvant in the treatment of acute exacerbations of COPD in the emergency department: A double-blind randomized clinical trial[J]. Ethiop J Health Sci, 2021, 31(2): 267-274.
28
Pogozheva AV, Kodentsova VM, Sharafetdinov KK. [The role of magnesium and potassium in preventive and therapeutic nutrition][J]. Vopr Pitan, 2022, 91(5): 29-42.
29
Ni H, Aye SZ, Naing C. Magnesium sulfate for acute exacerbations of chronic obstructive pulmonary disease[J]. Cochrane Database Syst Rev, 2022, 5(5): CD013506.
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