| Objective: Retrospective analysis of the causes and clinical manifestations,changes of related biochemical indicators,diagnosis and treatment outcome of inpatients with hyponatremia in the First Affiliated Hospital of Dalian Medical University were carried out,and its clinical characteristics were discussed,and preventive measures were put forward.It is expected to improve the level of diagnosis and treatment of hyponatremia.Methods: Retrospective analysis of 601 cases of inpatients with definite diagnosis of hyponatremia and complete case data in our hospital from January 1,2016 to June 30,2017.The clinical data included age,gender,clinical manifestations,basic diseases,auxiliary examinations,treatment and prognosis.SPSS22.0 was used for statistical analysis.The data of all continuous variables are expressed as x ± s,two groups ofnormal distribution were compared with independent sample t test,variance analysis(F)was used for comparison between groups,non-parametric tests are used to compare groups of non-normal distributions,use percentage to express enumeration data.The ?2test was used to compare the disordered data groups.The non-parametric test was used to compare the ordered data groups.P< 0.05 was considered statistically significant.Results:1.The age range of patients with hyponatremia in our hospital was from 15 to 95 years,with an average age of 63.9±16.6 years.There were 398 cases over 60 years old,account for 66.2%.There were 128 patients between 45 and 59 years old,accountfor 21.3%.There were 75 patients under the 45 years old,account for 12.5%.The patients with hyponatremia in our hospital were mainly over 45 years old.,with a total of 87.5%.2.Among the patients with hyponatremia,327 cases(54.4%)were male and 274cases(45.6%)were female,and the ratio of men and women was about 1.19:1.3.Among the hospitalized hyponatremia patients,isotonic hyponatremia(osmotic pressure 275--310 m Osm/L)in 300 cases(49.9%),hypo-osmolar hyponatremia(osmotic pressure < 275 m Osm/L)in 296cases(49.3%),hypertonic hyponatremia(osmotic pressure>310 m Osm/L)in 5 cases(0.8%).4.According to the degree of hyponatremia,mild hyponatremia(serum sodium130~134mmol/L)in 325 cases(54%),moderate hyponatremia(serum sodium125-129mmol/l)in 168 cases(28%),profound hyponatremia(serum sodium<125mmol/l)in 108 cases(18%).Obviously,mild and moderate hyponatemia accounted for the majority of patients.5.The average age of the patients with mild hyponatremia was 61.50±17.77 years old,the average age of the patients in the moderate hyponatremia group was 65.92±15.28 years old,the average age of the patients with profound hyponatremia was 67.81± 13.44 years old,the average age of the profound hyponatremia group was the largest,the age of the patients with moderate and profound hyponatremia was higher than that of the mild,and the difference was statistically significant(P<0.05).6.The blood osmotic pressure of the patients with mild hyponatremia was280.34±6.47 m Osm/L,the blood osmotic pressure of the patients in the moderate hyponatremia group was270.80 ± 9.23 m Osm/L,the blood osmotic pressure of the patients with profound hyponatremia was253.77±10.19 m Osm/L.The osmotic pressure of the moderate and profound patients was lower than that of the mild,and the osmotic pressure in the profound patients was lower than that of the moderate,and the difference was statistically significant(P<0.05).7.The number of acute hyponatremia(<48h)was 62 cases(10.3%),chronic hyponatremia(?48h)539 cases(89.7%),the patients with hyponatremia admitted in our hospital were mainly chronic,accounting for 89.7%.8.The average age of patients in chronic hyponatremia group was 64.48±16.17 years.The average age of patients in acute hyponatremia group was 58.58±19.12 years.The age of patients with chronic hyponatremia was higher than that of patients with acute hyponatremia,the difference was statistically significant(P<0.05).9.The blood osmotic pressure of the patients with chronic hyponatremia was272.45±13.07 m Osm/L,and the blood osmotic pressure of the patients in the acute hyponatremia group was 276.81±8.27 m Osm/L.The osmotic pressure in patients with chronic hyponatremia was lower than that of patients with acute hyponatremia,the difference was statistically significant(P<0.05).10.The common causes of hyponatremia include respiratory diseases,central nervous system disease,digestive system disease.There were 181 cases of respiratory diseases(30.1%),156 cases of central nervous system disease(26%),and 98 cases of digestive system disease(16.3%).11.The common causes of acute hyponatremia include central nervous system disease(29 cases,46.8%),acute poisoning(8 cases,12.9%),and respiratory diseases(8cases,12.9%).The common causes of chronic hyponatremia include respiratory diseases(173 cases,32.2%),central nervous system diseases(127 cases,23.5%),and digestive system diseases(95 cases,17.5%).12.The clinical manifestation of patients with hyponatremia during admission,98 cases of fever(16.31%),59 cases of gastrointestinal symptoms(9.82%),54 cases of cough and expectoration(8.99%).13.The cure and improvement rates of hyponatremic patients were shown to be62.9% and 22.3 %,and the ineffeciency and mortality were10.3% and 4.5%.The difference between the patients with mild,moderate and profound hyponatremia after treatment was statistically significant(P<0.05).Among them,the prognosis of mild patients is better than that of profound patients.The difference was statistically significant(P<0.05),among which the efficacy of young patients was better than that of elderly patients.14.28 cases of hyponatremia were treated in the department of endocrinology in our hospital.The common causes of hyponatremia include diabetic ketoacidosis(15cases,54%),hypopituitarism(3 cases,10.7%),and syndrome of inappropriate antidiuretic hormone secretion(2 cases,7.1%).Conclusions:1.The patients with hyponatremia admitted in our hospital were mainly chronic.The average age of the chronic hyponatremia group was higher than that of the patientswith acute hyponatremia.2.Among the patients with hyponatremia,the majority of the patients were mild and moderate hyponatremia.The inpatients with hyponatremia were mainly over 45 years old,and there was no significant difference in the ratio of male and female.3.The common causes of hyponatremia include respiratory diseases,central nervous system disease,digestive system disease.4.Among the patients with hyponatremia,isotonic hyponatremia was the most common.5.The cause of hyponatremia in the department of endocrinology of our hospital was mainly diabetic ketoacidosis. |
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