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结核性脑膜炎（ TBM）是结核病中最严重的一种。低钠血症是 TBM 常见的并发症。 TBM合并低钠血症可加重脑水肿，导致颅内高压，甚至脑疝形成，处理不及时可危及生命。 TBM合并低钠血症最重要的两个原因是抗利尿激素分泌异常综合征和脑耗盐综合征。由于两者临床表现类似，导致诊断困难，容易漏诊、误诊，如果治疗不当会导致病情加重或死亡。及早发现及明确 TBM 合并低钠血症的原因，及时给予针对性治疗，可能有效降低TBM患者的病死率。“,”Tuberculous meningitis(TBM) is one of the most serious of tuberculosis.Hyponatremia is a common complication of TBM.TBM complicated with hyponatremia can aggravate cerebral edema,lead to intracranial hypertension,even cerebral hernia,and can endanger life without timely treatment.The two most important reasons of TBM complicated hypnatiremia are syndrome of inappropriate antidiuretic hormone and cerebral salt wasting syndrome.Because the clinical manifestations of the two syndromes are similar ,the diag-nosis is difficult,with easy missed diagnosis or misdiagnosis,and inappropriate treatment may lead to aggrava-tion or death.Early detection and clarification of reasons for TBM complicated with hyponatremia ,and timely targeted therapy,may effectively reduce the mortality of patients with TBM .