内科医生常见的电解质紊乱
Common electrolyte disorders for the internist.
摘要(中文译文)
电解质、酸碱及矿物质代谢紊乱是内科患者最常见且具有重要临床意义的问题之一。其发生反映了肾脏、骨骼、内分泌系统及细胞离子转运等受调控的稳态机制出现紊乱。低钠血症、高钠血症、低钾血症、高钾血症、代谢性酸中毒、代谢性碱中毒以及钙磷代谢异常等紊乱若未及时识别和恰当治疗，则与显著的发病率和死亡率相关。准确诊断需要深入理解潜在的病理生理机制、评估容量状态、解读实验室检查结果，并识别相关的肾脏、内分泌、药物及全身性因素。本综述阐述了调控电解质和酸碱稳态的生理机制，并讨论了内科医师常见的电解质紊乱的临床表现、诊断评估及循证管理。我们着重强调鉴别病因并应用实用的诊断流程来指导治疗决策。此外，本综述重点介绍了甲状旁腺激素、维生素D及成纤维细胞生长因子23对钙磷的相互关联调控及其在肾脏疾病和其他疾病中的相关性。通过将基础生理学与当前临床实践指南相结合，本综述为内科医师提供了一个实用框架，以自信地解决其所面临的电解质问题。
Abstract
Electrolyte, acid-base, and mineral metabolism disorders are among the most common and clinically significant problems experienced in internal medicine patients. Their development reflects disturbances in regulated homeostatic mechanisms involving the kidneys, bones, endocrine systems, and cellular ion transport. Disorders such as hyponatremia, hypernatremia, hypokalemia, hyperkalemia, metabolic acidosis, metabolic alkalosis, and abnormalities of calcium and phosphorus metabolism are associated with substantial morbidity and mortality when not promptly recognized and appropriately treated. Accurate diagnosis requires a deep understanding of the underlying pathophysiology, assessment of volume status, interpretation of laboratory findings, and identification of contributing kidney, endocrine, medications, and systemic factors. This review describes the physiological mechanisms governing electrolyte and acid-base homeostasis and discusses the clinical presentation, diagnostic evaluation, and evidence-based management of common electrolyte disorders encountered by Internists. We place emphasis on distinguishing etiologies and applying practical diagnostic algorithms to guide treatment decisions. In addition, the review highlights the interconnected regulation of calcium and phosphorus by parathyroid hormone, vitamin D, and fibroblast growth factor 23 and its relevance in kidney disease and other disorders. By integrating foundational physiology with current clinical practice guidelines, this review provides internists with a practical framework to solve electrolyte issues they face with confidence.
如何引用
AMA
Gates B Colbert, Ankur Shah, Stephanie Torres Rodriguez, Edgar V Lerma. Common electrolyte disorders for the internist.. Disease-a-month : DM. 2026; doi:10.1016/j.disamonth.2026.102209.
APA
Gates B Colbert, Ankur Shah, Stephanie Torres Rodriguez, Edgar V Lerma (2026). Common electrolyte disorders for the internist.. Disease-a-month : DM. https://doi.org/10.1016/j.disamonth.2026.102209
GB/T 7714
Gates B Colbert, Ankur Shah, Stephanie Torres Rodriguez, Edgar V Lerma. Common electrolyte disorders for the internist.[J]. Disease-a-month : DM, 2026 doi:10.1016/j.disamonth.2026.102209.
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