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血清钠高于145mmol/L时,称为高血钠症.因为钠是细胞外液的主要阳离子,因此高血钠症都伴有血浆渗透压升高.1 病因及发病机理根据高血钠症是否伴有细胞外液容量的改变可分为三种:高血钠症伴有细胞外液容量正常、减少及增加.1.1 高血钠症:细胞外液容量正常 此见于:1.1.1 水摄入减少 水摄入减少若不严重,临床上不会出现血容量减少,因为血管内液的含水量仅占体内总含水量的1/12.当体内缺水达6L时,血管内液只减少500ml.但血钠可升高.1.1.2 肾排出水量增加 肾排水量多于排钠量,而引起高血钠症,此常见于尿崩症.因抗利尿激素(ADH)的合成及分泌障碍而引起的尿崩症,称为中枢性尿崩症.因肾小管缺陷.对ADH反应不良而引起的尿崩症.称为肾性尿崩症.尿崩症的共同特点是:多尿、多饮、口渴.虽有多尿,但因有多饮,故血容量改变不大,但可有高钠血症.
Serum sodium is higher than 145mmol / L, called hypernatremia.As sodium is the main cation of extracellular fluid, so hypernatremia is accompanied by increased plasma osmolality.1 Etiology and pathogenesis According to hypernatremia Whether there is a change in the extracellular fluid volume can be divided into three types: hypernatremia associated with normal, decreased and increased extracellular fluid volume.1.1Hyndrolonemia: extracellular fluid volume is normal This is seen in: 1.1.1 water Into the reduction of reduced water intake if not serious, clinical blood volume does not decrease, because the water content of intravascular fluid only accounts for the total body water content of 1 / 12. When the body of water up to 6L, the intravascular fluid only decreased 500ml.But the blood sodium can be increased.1.1.2 renal excretion of water increased renal drainage more than the amount of sodium, causing hypernatremia, which is common in diabetes insipidus due to the synthesis and secretion of antidiuretic hormone (ADH) And caused by diabetes insipidus, known as central diabetes insipidus due to renal tubular defects caused by adverse reactions to ADH diabetes insipidus, known as renal diabetes insipidus diabetes insipidus common features are: polyuria, Drink more, thirsty, although polyuria, but due to drink more, so little change in blood volume, but may have hypernatremia.