临床较少见的真性糖尿病性白内障一例报告  

Rare True Diabetic Cataract: a Case Report

作　　者：张凌 崔光淑 郭启煜[2] 黄金华 ZHANG Ling;CUI Guang-shu;GUO Qi-yu;HUANG Jin-hua(Department of Endocrinolog,Zhongguancun Hospital ofBeijing,Beijing 100190,China;Department of Endocrinology,General Hospital of PLA Navy,Beijing 100048,China)

机构地区：[1]北京市中关村医院内分泌科,北京100190 [2]解放军海军总医院内分泌科,北京100048

出　　处：《临床误诊误治》2017年第12期34-36,共3页Clinical Misdiagnosis & Mistherapy

摘　　要：目的探讨真性糖尿病性白内障的临床特点。方法对我院收治的1例真性糖尿病性白内障的临床资料进行回顾性分析,并复习相关文献。结果本例因视物模糊1个月,尿酮阳性1 d入院。初步诊断为双眼白内障,后发现血糖升高,遂到我院就诊。查随机血糖29.87 mmol/L;尿糖(++++),尿酮(++);糖化血红蛋白13.0%;空腹、口服葡萄糖后1 h、2 h及3 h C肽分别为0.19 nmol/L、0.26 nmol/L、0.32 nmol/L、0.45 nmol/L。诊断为双眼真性糖尿病性白内障,予降糖、补液等治疗,后于外院行双眼白内障摘除术+人工晶状体植入术,术后视力恢复良好。随访1年,患者血糖控制良好,视力恢复正常。结论接诊年轻且病情进展较快的白内障患者,要考虑到真性糖尿病性白内障的可能,常规监测血糖,早期明确诊断,尽早予有效治疗,以改善预后。Objective To investigate clinical characteristics of true diabetic cataract. Methods Clinical data of 1 patient with true diabetic cataract was retrospectively analyzed, and the related literature was reviewed. Results The patient was admitted for blurred vision for 1 month and positive urine acetone body for 1 d. The patien＇s result was normal by medical examination 1 year ago, and primary diagnosis was binocular cataract, and then elevated blood sugar was found, so the patient was transferred to our hospital. Examinations showed that random blood sugar was 29. 87 mmol/L, urine sugar （ ＋ ＋ ＋ ＋）, urine acetone body （ ＋ ＋） and 13% glycosylated hemoglobin. Values of C peptides in fasting, 1 h, 2 h and 3 h after taking glucose orally were 0. 19 nmol/L, 0. 26 nmol/L, 0. 32 nmol/L and 0. 45 nmol/L respectively. The true diabetic cataract was confirmed. After treatments such as hypoglycemic and fluid replacement, binocular cataract extraction and intraocular lens im-plantation were performed in other hospital, and postoperative visual acuity recovered well. With follow-up for 1 year, the pa-tient＇s blood sugar was controlled well, and vision returned to normal. Conclusion Young cataract patients have rapid condi-tions development, clinicians should take into account the possibility of true diabetic cataracts, and routine monitoring of blood sugar should be given to confirm the diagnosis early in order to give effective treatment as early as possible and improve progno-sis.

关 键 词：白内障 糖尿病 2型 糖尿病视网膜病变 

分 类 号：R587.2[医药卫生—内分泌] R779.6[医药卫生—内科学]