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1例丙戊酸钠致儿童抗利尿激...泌失调综合征报道并文献复习_程义.pdf
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戊酸 儿童 利尿 失调 综合征 报道 文献 复习 程义
for treating symptomatic non-typhoidal Salmonella infection J.Cochrane database of systematic reviews,2012,11(11):CD001167.7 ELENGA N,CUADRO E,LONG L,et al.Salmonella enterica serovar Panama meningitis in exclusive breastfeeding infants:report of 4 cases,clinical features and therapeutic challenges J.Medicine,2017,96(19):e6665.8 GEME J W,HODES H L,MARCY S M,et al.Consensus:management of Salmonella infection in the first year of life J.Pediatr Infect Dis J,1988,7(9):615-621.9 BENENSON S,RAVEH D,SCHLESINGER Y,et al.The risk of vascular infection in adult patients with nontyphi Salmonella bacteremia J.Am J Med,2001,110(1):60-63.10 张泽辉,宋雪娇,黄程程,等.细菌的获得性耐药机制研究进展J.动物医学进展,2017,38(1):74-77.11 王选锭,沈华浩.临床常用的 内酰胺酶抑制剂能否治疗产型头孢菌素酶细菌的感染?J.中华结核和呼吸杂志,2002,25(12):710-712.12 DIXON J M.Effect of antibiotic treatment on duration of excretion of Salmonella typhimurium by children J.Brit Med J,1965,2(5474):1343-1345.13 KASSIS I,DAGAN R,CHIPMAN M,et al.The use of prophylactic furazolidone to control a nosocomial epidemic of multiply resistant Salmonella typhimurium in pediatric wards J.Pediatr Infect Dis J,1990,9(8):551-555.14 DYSON C,RIBEIRO C D,WESTMORELAND D.Large scale use of ciprofloxacin in the control of a Salmonella outbreak in a hospital for the mentally handicapped J.J Hosp Infect,1995,29(4):287-296.15 杜敏,谢晓丽.162 例小儿鼠伤寒沙门菌肠炎临床特点及耐药性分析J.儿科药学杂志,2018,24(9):12-14.16 CHEN H,SHI T,LU Y,et al.Antimicrobial resistance,genetic diversity and virulence genes of Salmonella typhimurium isolated in infant with acute diarrhea in Fuzhou,China,2015-2017 J.Clin Lab,2019,65(5):779-787.17 SIRINAVIN S,THAVORNNUNTH J,SAKCHAINANONT B,et al.Norfloxacin and azithromycin for treatment of nontyphoidal Salmonella carriers J.Clin Infect Dis,2003,37(5):685-691.(编辑:杨丹)(收稿日期:2021-11-23 修回日期:2022-01-18)doi:10.13407/ki.jpp.1672-108X.2023.07.003论著1 1 例例丙丙戊戊酸酸钠钠致致儿儿童童抗抗利利尿尿激激素素分分泌泌失失调调综综合合征征报报道道并并文文献献复复习习程义1,2,王永霞1,高铭1,马秀伟1(1.解放军总医院第七医学中心,北京 100700;2.仁怀市人民医院,贵州遵义 564500)基金项目:吴阶平医学基金会临床科研专项资助基金,编号 320.6750.2020-06-59。作者简介:程义(1989.07-),男,大学本科,住院医师,主要从事儿童神经系统疾病研究,E-mail:980817413 。通信作者:马秀伟(1976.08-),女,博士,副主任医师,主要从事儿童神经系统疾病研究,E-mail:pony007 。摘要目的:探讨儿童长期服用丙戊酸钠(VPA)导致抗利尿激素分泌失调综合征(SIADH)的发病机制、诊疗经过,提高临床医师认识水平。方法:总结 1 例 TBC1D24 基因突变相关癫痫儿童长期服用 VPA 导致 SIADH 的临床资料,并以“丙戊酸钠”和“抗利尿激素分泌失调综合征”为关键词在中国知网和 PubMed 数据库中进行文献检索和分析。结果:该患儿 12 岁,因 TBC1D24 基因突变相关癫痫长期服用 VPA,因癫痫发作伴意识障碍入院,住院后期发现重度低钠血症,积极补充 3%氯化钠、限液、利尿等对症治疗后血钠水平未恢复正常,将 VPA 减量后血钠水平恢复正常,排除可能引起低钠血症的其他病因后确诊为 VPA 致SIADH,多次门诊随访监测显示血钠水平正常。检索数据库后共收集 7 篇相关病例报道,减停 VPA 后 10 例成人患者均血钠水平恢复正常。结论:儿童长期服用 VPA 出现顽固性低钠血症时,需考虑 VPA 致 SIADH,及时调整治疗方案,避免出现严重的不良事件。关键词丙戊酸钠;儿童;抗利尿激素分泌失调综合征;低钠血症中图分类号R969.3 文献标识码A 文章编号1672-108X(2023)07-0010-04A Case of Syndrome of Inappropriate Antidiuretic Hormone Secretion Induced by Sodium Valproate and Literature ReviewCheng Yi1,2,Wang Yongxia1,Gao Ming1,Ma Xiuwei1(1.The Seventh Medical Center of PLA General Hospital,Beijing100700,China;2.Renhuai Peoples Hospital,Guizhou Zunyi 564500,China)Abstract Objective:To probe into the pathogenesis,diagnosis and treatment process of syndrome of inappropriate antidiuretic hormone secretion(SIADH)induced by long-term use of sodium valproate(VPA)in children,so as to improve the awareness of clinicians.Methods:Clinical data of SIADH induced by long-term use of VPA in a child with TBC1D24 gene mutation-related epilepsy were summarized.“Sodium valproate”and“syndrome of inappropriate antidiuretic hormone secretion”were used as keywords to 01儿科药学杂志 2023 年第 29 卷第 7 期 Journal of Pediatric Pharmacy 2023,Vol.29,No.7perform literature search and analysis in CNKI and PubMed databases.Results:The 12-year-old child took VPA for TBC1D24 gene mutation-related epilepsy for a long time,and was admitted into the hospital for epilepsy accompanied by consciousness disorder.Severe hyponatremia was found in the later stage of hospitalization,and the blood sodium level did not return to normal state after symptomatic treatment such as 3%sodium chloride,fluid restriction,and diuresis.The serum sodium level returned to normal state after VPA dose reduction.After excluding other causes that may induce hyponatremia,the diagnosis of SIADH induced by VPA was confirmed.Multiple outpatient follow-up monitoring showed that the serum sodium level was normal.A total of 7 related case reports were collected after searching the databases,and serum sodium levels returned to normal state after VPA was reduced in 10 adult patients.Conclusion:When children develop refractory hyponatremia after long-term use of VPA,SIADH induced by VPA should be considered,and the treatment regimen should be adjusted in time to avoid severe adverse events.Keywordssodium valproate;children;syndrome of inappropriate antidiuretic hormone secretion;hyponatremia 抗利尿激素分泌失调综合征(syndrome of inappropriate antidiuretic hormone secretion,SIADH)是指内源性抗利尿激素(antidiuretic hormone,ADH)分泌异常增多或作用增强,导致水潴留、尿排钠增多以及稀释性低钠血症等临床表现的一组综合征1。SIADH 起病隐匿,病因复杂,目前常见的病因有恶性肿瘤、肺部疾病、中枢神经系统病变、药物(卡马西平、噻嗪类利尿剂、氟喹诺酮类抗生素等)及特发性(遗传、疼痛、应激等)因素等2。丙戊酸钠(sodium valproate,VPA)是一种广谱抗癫痫药,其

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