BACKGROUND Severe hyponatremia is considered a rare complication of pituitrin,which is widely used for the treatment of pulmonary hemorrhage.However,the management of pituitrin-associated hyponatremia can be challengi...BACKGROUND Severe hyponatremia is considered a rare complication of pituitrin,which is widely used for the treatment of pulmonary hemorrhage.However,the management of pituitrin-associated hyponatremia can be challenging because a rapid correction of hyponatremia may cause the development of osmotic demyelination syndrome,resulting in life-threatening neurological injuries.CASE SUMMARY A 20-year-old Chinese man with massive hemoptysis developed symptomatic hyponatremia(116 mmol/L)after therapy by a continuous intravenous drip of pituitrin.To normalize his serum sodium,a hypertonic saline infusion was applied for 3 d,and the pituitrin administration was stopped concurrently.Then,an overly rapid increase in serum sodium level(18 mmol/L in 24 h)was detected after treatment.One day later,the patient experienced a sudden onset of generalized tonic-clonic seizures,as well as subsequent dysarthria and dystonia.Magnetic resonance imaging revealed increased signal intensity in the bilateral symmetric basal ganglia on the T2-weighted images,compatible with a diagnosis of extrapontine myelinolysis.The patient received an intravenous administration of high-dose corticosteroids,rehabilitation,and neurotrophic therapy.Finally,his clinical abnormalities were vastly improved,and he was discharged with few residual symptoms.CONCLUSION Physicians should be fully aware that pituitrin can cause profound hyponatremia and its correction must be performed at a controlled rate to prevent the development of osmotic demyelination syndrome.展开更多
Objective: To study the curative effect of silybin combined with pituitrin-phentolamine for pulmonary tuberculosis complicated by acute hemoptysis. Methods: A total of 78 patients with pulmonary tuberculosis complicat...Objective: To study the curative effect of silybin combined with pituitrin-phentolamine for pulmonary tuberculosis complicated by acute hemoptysis. Methods: A total of 78 patients with pulmonary tuberculosis complicated by acute hemoptysis who were treated in this hospital between December 2013 and April 2017 were divided into control group (n=39) and silybin group (n=39) by random number table. Control group received pituitrin-phentolamine hemostasis therapy, silybin group received pituitrin-phentolamine combined with silybin therapy, both were treated for 1 week. The differences in peripheral blood liver function and coagulation index levels as well as serum oxidative stress index contents were compared between the two groups of patients before treatment and after 1 week of treatment. Results:Before treatment, the differences in peripheral blood liver function and coagulation index levels as well as serum oxidative stress index contents were not statistically significant between the two groups. After 1 week of treatment, peripheral blood liver function indexes ALT, AST, ALP and STB contents of silybin group were lower than those of control group;peripheral blood coagulation indexes PT, APTT and TT levels were lower than those of control group whereas Fib level was higher than that of control group;serum oxidative stress indexes AOPPs and LHP contents were lower than those of control group whereas GSH-Px and T-AOC contents were higher than those of control group. Conclusion: pituitrin-phentolamine combined with silybin therapy can effectively protect the liver function, optimize the coagulation function and reduce the oxidative stress response in patients with pulmonary tuberculosis complicated by acute hemoptysis.展开更多
基金Supported by the Department of Health of Zhejiang Province,China,No.2016RCA013
文摘BACKGROUND Severe hyponatremia is considered a rare complication of pituitrin,which is widely used for the treatment of pulmonary hemorrhage.However,the management of pituitrin-associated hyponatremia can be challenging because a rapid correction of hyponatremia may cause the development of osmotic demyelination syndrome,resulting in life-threatening neurological injuries.CASE SUMMARY A 20-year-old Chinese man with massive hemoptysis developed symptomatic hyponatremia(116 mmol/L)after therapy by a continuous intravenous drip of pituitrin.To normalize his serum sodium,a hypertonic saline infusion was applied for 3 d,and the pituitrin administration was stopped concurrently.Then,an overly rapid increase in serum sodium level(18 mmol/L in 24 h)was detected after treatment.One day later,the patient experienced a sudden onset of generalized tonic-clonic seizures,as well as subsequent dysarthria and dystonia.Magnetic resonance imaging revealed increased signal intensity in the bilateral symmetric basal ganglia on the T2-weighted images,compatible with a diagnosis of extrapontine myelinolysis.The patient received an intravenous administration of high-dose corticosteroids,rehabilitation,and neurotrophic therapy.Finally,his clinical abnormalities were vastly improved,and he was discharged with few residual symptoms.CONCLUSION Physicians should be fully aware that pituitrin can cause profound hyponatremia and its correction must be performed at a controlled rate to prevent the development of osmotic demyelination syndrome.
文摘Objective: To study the curative effect of silybin combined with pituitrin-phentolamine for pulmonary tuberculosis complicated by acute hemoptysis. Methods: A total of 78 patients with pulmonary tuberculosis complicated by acute hemoptysis who were treated in this hospital between December 2013 and April 2017 were divided into control group (n=39) and silybin group (n=39) by random number table. Control group received pituitrin-phentolamine hemostasis therapy, silybin group received pituitrin-phentolamine combined with silybin therapy, both were treated for 1 week. The differences in peripheral blood liver function and coagulation index levels as well as serum oxidative stress index contents were compared between the two groups of patients before treatment and after 1 week of treatment. Results:Before treatment, the differences in peripheral blood liver function and coagulation index levels as well as serum oxidative stress index contents were not statistically significant between the two groups. After 1 week of treatment, peripheral blood liver function indexes ALT, AST, ALP and STB contents of silybin group were lower than those of control group;peripheral blood coagulation indexes PT, APTT and TT levels were lower than those of control group whereas Fib level was higher than that of control group;serum oxidative stress indexes AOPPs and LHP contents were lower than those of control group whereas GSH-Px and T-AOC contents were higher than those of control group. Conclusion: pituitrin-phentolamine combined with silybin therapy can effectively protect the liver function, optimize the coagulation function and reduce the oxidative stress response in patients with pulmonary tuberculosis complicated by acute hemoptysis.
