1.低钠血症在临床上,现多以ADH为基轴对低Na血症进行分类,这有助于理解低Na血症的病理生理以及选择治疗方法。包括①ADH依赖型低Na血症:多见于肺小细胞癌时的异位性ADH产生肿瘤、以及原发性垂体后叶ADH分泌过多所致的ADH分泌异常综合征(SIADH)。垂体后叶原发性ADH分泌过多,多由于中枢神经和呼吸系统的病变以及药物等引起。此时血浆渗透压虽已降低,ADH分泌仍亢进,使肾远曲小管与集合管对水的重吸收增多,体液量增加,而引起低Na血症。同时,循环血量的增加,使紧小球滤过 1. Hyponatremia In clinical practice, ADH is now mostly based on the classification of hyponatraemia, which helps to understand the pathophysiology of hyponatremia and the choice of treatment. Including ① ADH-dependent hyponatremia: more common in small cell lung cancer atopic ADH-producing tumors, and primary ADH secretion of the posterior pituitary ADH secretion syndrome (SIADH). Pituitary primary ADH excessive secretion, mostly due to central nervous and respiratory diseases and drugs caused. Although the plasma osmolality has been reduced, ADH secretion is still hyperthyroidism, the renal distal convoluted tubules and tubes of water reabsorption increased, increased body fluid, causing hyponatremia. At the same time, the increase in circulating blood volume, so tight ball filtration