Analysis Of The Etiology Of Hospitalized Patients With Hyponatremia

Objective:This study has a retrospective analysis on the pathogenic factor, prognosis and related biochemical criterions changes of hyponatremia, to provide prevention and control measures related to hyponatremia. This will help the clinician correctly identify an deal with the patients suffering from hyponatremia, and then improve the survival rate and cure rate of the patients and decrease death rate.Material and method:This research is selected the hyponatremia patients that were hospitalized in the First Affiliated Hospital of Dalian Medical University from Jun1st,2012to Dec31st,2013as the objects of study, totally398cases.According to the serum sodium level when hyponatremia occurred to them, they were divided into light hyponatremia (serum Na+between130～134mmol/L), medium hyponatremia (serum Na+between120～129mmol/L) and heavy hyponatremia (serum Na+<120mmol/L)groups. It is collected clinical data:age, gender, causes, random venous blood glucose, serum sodium ion, serum potassium ion, serum chloride ion, serum calcium ion, serum phosphonium ion, blood urea nitrogen, creatinine, plasmaosmotic pressure, alanin aminotransferase, aspartate aminotransferase, y-glutamyl transferase, alkaline phosphatase, total bilirubin, albumin to do retrospective analysis.Results:(1) Among the398cases of hospitalized hyponatremia patients, the ones with light hyponatremia are the most (200, about50.25%), and then those with modium hyponatremia(164,41.21%), while those with heavy hyponatremia occupy the least proportion(34,8.54%);(2) Comparing the ages of patients of the three groups, the average age of the heavy group is the oldest, the difference compared with the light group and the medium group has statistical significance (P<0.05), and the difference between the medium group and the light group has no statistical significance (P>0.05);(3) Comparing with the light group, the blood Cl-of the medium group and the heavy group are reduced in turn, each difference has statistical sinificance(P<0.05), the difference between the heavy group and the medium group has statistical significance (P<0.05);(4) Comparing with the light group, the plasmaosmotic pressure of the medium group and the heavy group are reduced in turn, each difference has statistical sinificance(P<0.05), the difference between the heavy group and the medium group has statistical significance (P<0.05);(5) the causes of hyponatremia are mostly pulmonary diseases, totally103cases (25.88%), and then74cases of central nervous system disease (18.59%),56cases of cancer (14.07%),53cases of digestive system disease (13.32%);(6) As for the case fatality rate of three groups of patients, the heavy hyponatremia group is the highest (17.65%), but the differences among each group have no statistical significance (P>0.05);(7) The hospitalized hyponatremia patients are mostly hypo-osmolar hyponatremia (217,54.52%), while among the patients suffering from hypo-osmolar hyponatremia, normovolemic hyponatremia patients (153,70.51%) are the most;169cases are isotonic hyponatremia(about42.46%);12cases are hypertonic hyponatremia(about3.02%)(8) Each of the age and the glomerular filtration rate has a negative correlation with blood Na+, and the difference has statistical significance (the correlation coefficient respectively is-0.22、-0.13; P<0.05); blood Na+has a positive correlation with blood Cl-and the blood osmotic pressure(the correlation coefficient respectively is0.67、0.70; P<0.05).Conclusion:(1) Among the hospitalized hyponatremia patients, the underlying diseases are mostly pulmonary disease, central nervous system disease and cancer;(2) Among the hospitalized hyponatremia patients, they are mostly patients suffering from hypo-osmolar hyponatremia, among which, normovolemic hyponatremia patients are the most;(3) the hospitalized hyponatremia patients are mostly the aged, and the age has a negative correlation with Serum sodium level; and the aged have a relatively high case fatality rate.(4) The hyponatremia is often accompanied by hypochloridemia, and blood Na+has a positive correlation with blood Cl-.