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大剂量腹安酸(Furosemide)可能是引起高渗性非酮症糖尿病昏迷的一个因素。但广为应用的中剂量或小剂量腹安酸,也可能有关连。在一些情况下,由于大量进食甜饮料,也可能引起这种昏迷类型。本文报告一例为这二种因素联合所致。病者62岁,男性。突然发生虚脱,两腿衰弱无力。其父亲有糖尿病病史。未见神经异常,但有咽部炎症伴发热。脉搏规则,112/分,血压170/120mmHg。有奔马律,肺底啰音和肝大。诊为支气管肺炎及高血压继发心衰。胸部X线显示心脏扩大,右肺叶间裂积液,两侧肺底阴影。心电图为窦性心动过速,电轴左偏,前外侧壁的导联见有S-T段压低。咽拭培养有溶血性链球菌生长。无糖尿,餐后血糖为6.6mmol/l。腹安酸40mg,一日二次,应用氨苄青霉素和补充钾,
High doses of furosemide may be a contributing factor to hypertonic non-ketotic diabetic coma. But the widely used medium dose or low dose of abdominal acid, may also be related. In some cases, this type of coma can also be caused by eating lots of sweet drinks. This article reports an example of the combination of these two factors. The patient is 62 years old, male. Sudden collapse, legs weak and feeble. His father had a history of diabetes. No neurological abnormalities, but pharyngeal inflammation with fever. Pulse rules, 112 / min, blood pressure 170 / 120mmHg. A gallop, lung rales and liver base. Diagnosis of bronchial pneumonia and hypertension secondary to heart failure. Chest X-ray showed enlargement of the heart, right lobar fissure fluid, both sides of the bottom of the lung shadow. Electrocardiogram for sinus tachycardia, left axis deviation, anterior lateral wall leads seen S-T depression. Throat swab culture hemolytic streptococcus growth. No diabetes, postprandial blood glucose was 6.6mmol / l. Abdominal acid 40mg, twice a day, the application of ampicillin and potassium supplement,