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| 題 名 | 鋰鹽引發腎原性尿崩:一例報告=Lithium-Induced Nephrogenic Diabetes Insipidus in a Patient with Bipolar Disorder |
|---|---|
| 作 者 | 陳炯鳴; 劉珣瑛; 楊鈞; 吳志仁; 謝宏杰; | 書刊名 | 臺灣精神醫學 |
| 卷 期 | 11:4 1997.12[民86.12] |
| 頁 次 | 頁68-75 |
| 分類號 | 415.74 |
| 關鍵詞 | 鋰鹽; 雙極性情感疾患; 腎原性尿崩症; Lithium; Bipolar disorder; Nephrogenic diabetes insipidus; |
| 語 文 | 中文(Chinese) |
| 中文摘要 | 目的︰本報告可作為處理長期接受鋰鹽治療而引起多尿病人時之參考。病例報告︰個案為一31歲男性,八年前罹患雙極性情感疾患,六年前起規則以鋰鹽治療,由於自四年前起平均每天尿量皆大於10000 cc,因此我們作了一系列包括糖尿病、高血鈣、低血鉀、原發性劇渴症、中樞性尿崩症、腎原性尿崩症的鑑別診斷以確定其病因,在確定為腎原性尿崩症之後又分別先後以indomethacin; hydrochlorothiazide加amiloride合併治劑治療。結果,indomethacin對於病人的尿量減少及增加尿液滲透壓並沒有太大的改善;然而,在hydrochlorothiazide以及amiloride合併治療下,明顯地減少了病人的尿量及增加尿液滲透壓。結論︰本系列的鑑別診斷對於確定其病因是十分重要的;同時,indomethacin並沒有如先前文獻所提的對本病人提供太大幫助,而hydrochlorothiazide及amiloride的合併治療,則明顯地改善了病人的腎原性尿崩症。 |
| 英文摘要 | Objective: Providing guidance for the different diagnosis and management of a bipolar disorder patient with polyuria treated by lithium for long time. Case Report: A 31-year-old male with an eight-year history of bipolar disorder and a history of lithium treatment in recent six years. Because the patient's average urine output had been more than 10000 cc/24hr during the past four years, a series of differential diagnoses including diabetes mellitus, hypercalcinemia, hypokalemia, primary polydipsia, central diabetes insipidus, nephrogenic diabetes insipidus were investigated to ascertain the etiology of polyuria. Nephrogenic diabetes insipidius was comfirmed after a water restrictive test and desmopressin acetate challenge. The patient was initially treated with indomethacin 150 mg/day, but this course of treatment failed to increase the urine osmolality. The patient was then placed on a regimen of hydrochlorothiazide-amiloride combination 100 mg & 10 mg/day. Subsequently, the significant reduction in urine output and elevation of urine osmolality was noted during four month follow-up period. Conclusion: This series of examinations for differential diagnosis was important in making sure the etiology of polyuria; besides, hydrochlorothiazide-amiloride combination was effective in the treatment but indomethacin was ineffective. |
本系統中英文摘要資訊取自各篇刊載內容。