中枢性尿崩症的治疗
- Author
- Daniel G Bichet, MD
Daniel G Bichet, MD
- Professor of Medicine
- Universite de Montreal
- Section Editors
- Richard H Sterns, MD
Richard H Sterns, MD
- Editor-in-Chief — Nephrology
- Section Editor — Fluid and Electrolytes
- Professor Emeritus
- University of Rochester School of Medicine and Dentistry
- Michael Emmett, MD
Michael Emmett, MD
- Editor-in-Chief — Nephrology
- Section Editor — Fluid and Electrolytes
- Chief of Internal Medicine
- Baylor University Medical Center
- Joseph I Wolfsdorf, MB, BCh
Joseph I Wolfsdorf, MB, BCh
- Section Editor — Pediatric Endocrinology
- Professor of Pediatrics
- Harvard Medical School
- Deputy Editors
- John P Forman, MD, MSc
John P Forman, MD, MSc
- Senior Deputy Editor — UpToDate
- Deputy Editor — Nephrology
- Assistant Professor of Medicine
- Harvard Medical School
- Alison G Hoppin, MD
Alison G Hoppin, MD
- Deputy Editor — Pediatrics
- Assistant Professor of Pediatrics, Part-time
- Harvard Medical School
- Translators
- 夏鹏, 住院医师
夏鹏, 住院医师
- 北京协和医院肾内科
引言
中枢性尿崩症(diabetes insipidus, DI)的主要症状包括浓缩功能障碍所致的多尿、夜尿和烦渴。这一疾病的主要治疗目标是降低尿排出量，通常通过提高抗利尿激素(antidiuretic hormone, ADH)[又称精氨酸加压素(arginine vasopressin, AVP)]的活性来实现。
补充先前已丢失的和正在丢失的液体也很重要。大多数中枢性DI患者的血浆钠浓度为正常或仅轻度升高，这是由于同时刺激渴感，而最大程度地降低了净失水的程度。然而，当渴感受损或患者无法补充水时，可出现高钠血症[1]。纠正高钠血症需要补充这些丢失的自由水。 (参见“高钠血症的治疗”)
中枢性DI的治疗将总结在此。该病病因和多尿患者的诊断方法将单独讨论。 (参见“中枢性尿崩症的临床表现和病因”和“多尿和尿崩症的诊断”)
治疗的选择
对中枢性DI患者多尿的治疗，有3种主要方法：
●去氨加压素，这是一种ADH类似物，几乎是所有患者的首选药物。
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To continue reading this article, you must log in with your personal, hospital, or group practice subscription. For more information or to purchase a personal subscription, click below on the option that best describes you:Literature review current through: 2017-07 . | This topic last updated: 2016-01-11.The content on the UpToDate website is not intended nor recommended as a substitute for medical advice, diagnosis, or treatment. Always seek the advice of your own physician or other qualified health care professional regarding any medical questions or conditions. The use of this website is governed by the UpToDate Terms of Use ©2017 UpToDate, Inc.References- Mavrakis AN, Tritos NA. Diabetes insipidus with deficient thirst: report of a patient and review of the literature. Am J Kidney Dis 2008; 51:851.
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