Clinical Characteristics Of 128 Hospitalized Patients With The Syndrome Of Inappropriate Antidiuretic

ObjectiveTo summarize and analyze the clinical features and etiology distribution in hos-pitalized patients with the Syndrome of Inappropriate Antidiuretics (SIAD)during the past 25 years.Methods1. All data of patients with SIAD admitted to Chinese PLA general hospital since 1991.01 to 2016.01 were collected.The sex ratio, visiting ages, final diagnosis, the year of hospitalization, therapeutic methods were retrospectively analyzed.2. Among all included cases,we studied the discrepancy in etiologies of the patients with SIAD.Patients'demographics data,final diagnosis,imageological examina-tions, and therapeutic methods were retrospectively analyzed.Results1.?During the past 25 years,128 patients with SIAD were admitted to the Chinese PLA General Hospital,of whom,97 males and 31 females.The overall mean age was 60.87±14.55 years old.?SIAD patients came to see a doctor in different departments and the variety of the departments gradually increased year by year. ?The laboratory examination showed serum sodium,serum chloride and serum osmolality were at low level.And serum uric acid, serum creatinine were lower limit of normal?Fluid restriction was regarded as first-line treatment, and the hospitalized patients with SIAD in endocrinology department had obtained the best therapeutic effect in our hospital (p< 0.05).2.?The main reason for the SIAD patients to see a doctor was unknown hypona-tremia.The most frequent causes of increased inappropriate secretion of vaso-pressin were malignancy and benign diseases of the lung and central nervous system.38.28% of the SIAD patients was diagnosed with malignancy diseases. ?During the past 25 years,the proportion of malignancy diseases declined from 57.13% to 36.76%(p<0.05); the proportion of pulmonary infection rose from 14.29% to 35.29%(p<0.05).And the proportion of SIAD with unidentified causes rose from 0 to 13.24%.?The average age of patients with malignancy diseases was younger than that with pulmonary infection.?The patients with malignancy diseases had the lowest serum sodium and serum osmolality in all SIAD patients.?CT did demonstrate a really higher diagnostic value in chest and brain test.?After diagnosed as SIAD,three patients had been diagnosed with tumor.Conclusion1. The number of patients with SIAD gradually increased during the past 25 years.2. SIAD patients visit hospital via different departments, among which the endo-crinology department account for the largest part.3. We should consider such clinical hyponatremia as SIAD,when patients'serum uric acid and serum creatinine are all at low level.And when the serum sodium of a patient is below 118.1mmol/L,we should exclude tumor at first.4. The etiological and symptomatic treatment should be used at the same time.Even though fluid restriction has been regarded as the most efficient and effective therapy till now, once that is futile, impractical, nor unpalatable, vaptans and loop diuretics therapy should be considered, instead.5. SIAD could be attributed to multifarious etiological factors. Malignancy as well as pulmonary infection account for larger ratios.6. When choosing the optimal tests to reveal the primary causes,clinical manifest-ation and laboratory examination should be taken into consideration. Patients with unidentified causes should be followed up for at least one year until the majority of possible hidden causes (e.g. malignancy and tuberculosis) emerged.