[在临床病例中诊断精神性多尿症]。

E B Kazangapov, L N Belchikova
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摘要

多尿症是一种病理上的口渴,通过大量摄入水来满足,可表现为各种躯体或精神疾病,乍一看与真正的血管加压素缺乏症相似。中枢性糖尿病(CDI)是下丘脑-垂体区域的一种疾病,其特点是肾脏无法重吸收水分和浓缩尿液,其基础是血管加压素的合成或分泌缺陷,表现为严重口渴和排出大量低渗尿液。该病在人群中的发病率为 1:25,000,是一种相当罕见的下丘脑-垂体病变。发病高峰在 30 至 40 岁之间。根据各种文献资料,该病的发病率没有性别差异,但以莫斯科人口为例,女性在 CND 发病率结构中占多数,比例为 2.2:1。在诊断原发性多尿症的困难方面存在明显的缺陷,其原因在于水中毒的表现形式,因此这种疾病需要医护人员掌握明确的诊断标准,并在治疗中采用跨学科的方法。以本临床病例为例,我们将尝试强调精神性多尿症与精氨酸加压素(AVP)或中枢性糖尿病(CDI)真正缺乏症的鉴别诊断标准,这些标准可在实际临床实践中应用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[Diagnosis of psychogenic polydipsia in the type of clinical case].

Polydipsia is a pathologically increased thirst, satisfied by the intake of water in large quantities, which can manifest itself in various somatic or mental diseases and at first glance is similar to a true vasopressin deficiency. Central diabetes insipidus (CDI) is a disease of the hypothalamic-pituitary region characterized by the inability of the kidneys to reabsorb water and concentrate urine, which is based on a defect in the synthesis or secretion of vasopressin and is manifested by severe thirst and excretion of large amounts of hypotonic urine. The prevalence of the disease in the population is 1:25,000, which characterizes it as a fairly rare pathology of the hypothalamic-pituitary region. The peak incidence is between 30 and 40 years of age. According to various literary sources, the disease is not characterized by gender differences in prevalence, however, on the example of the Moscow population, women prevailed in the incidence structure of CND in a ratio of 2.2:1. Insidiousness, with apparent absences in the difficulty of diagnosing primary polydipsia, lies in the manifestations of water intoxication, thus this condition requires knowledge of clear diagnostic criteria by healthcare professionals and an interdisciplinary approach in the treatment of this condition. On the example of this clinical case, we will try to highlight the differential diagnostic criteria for psychogenic polydipsia in comparison with the true deficiency of arginine vasopressin (AVP) or central diabetes insipidus (CDI), which can be applied in real clinical practice.

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