特利加压素导致低钠血症性脑病的病例分析并文献复习

目的： 提醒临床医师及药师在临床工作中应警惕特利加压素可能导致的低钠血症性脑病。方法： 报道1例使用特利加压素出现低钠血症性脑病最终导致患者死亡的案例，并复习国内外相关文献进行分析讨论。结果： 检索到3篇使用特利加压素至低钠血症性脑病的个案报道，但均未引起影像学改变且停药后神经系统症状得以恢复；在回顾性研究中，发现使用特利加压素发生低钠血症的危险因素可能有：年龄小、基线高血钠水平、长疗程（>5 d）以及较好的肝功能（低MELD或Child评分）。结论： 特利加压素引起的低钠血症可能导致不可逆的神经系统并发症，使用该药期间应严密监测血钠，尤其是有高危因素的患者。

Case analysis of hyponatremia encephalopathy caused by terlipressin and literature review

OBJECTIVE To remind clinicians and pharmacists of the possible hyponatremic encephalopathy caused by terlipressin in clinical work.METHODS A case report of patients with hyponatremia encephalopathy caused by terlipressin who eventually died was reported, and the related literatures were reviewed for analysis and discussion.RESULTS Three case reports of hyponatremic encephalopathy using terlipressin were retrieved, but none of them caused imaging changes and neurological symptoms and recovered after drug withdrawa. In the retrospective study, it was found that the risk factors for hyponatremia caused by the use of terlivasopressin may be as follows:young age, baseline high blood sodium levels, long course of treatment (>5 days) and better liver function (low MELD or Child score).CONCLUSION Terlipressin-induced hyponatremia may lead to irreversible neurological complications, and serum sodium should be closely monitored during the use of this drug, especially in patients with factors.