儿童高渗性非酮症糖尿病昏迷伴横纹肌溶解致急性肾功衰一例及文献分析  

Analysis of Literatures and 1 Case with Acute Renal Failure Caused by the Hyperosmolar Nonketotic Diabetic Coma with Rhabdomyolysis in Children

作　　者：于飞[1] 孙文君 方海宁[1] 祝婕[1] 苏杭[1] YU Fei;SUN Wen-jun;FANG Hai-ning;ZHU fie;SU Hang(（Department of Endocrinology and Hereditary Metabolism,Hubei Women＇s and Children＇s Hospital,Wuhan,Hubei Province,430070 Chin)

机构地区：[1]湖北省妇女儿童医院儿童内分泌遗传代谢科,湖北武汉430070

出　　处：《糖尿病新世界》2018年第1期30-31,157,共3页Diabetes New World Magazine

摘　　要：目的报道儿童Ⅰ型糖尿病高渗性非酮症糖尿病昏迷(HONK)并发横纹肌溶解症(RM)、急性肾损伤(AKI)的临床诊治经验。方法分析1例儿童Ⅰ型糖尿病高渗性非酮症糖尿病昏迷伴横纹肌溶解症并发急性肾功能衰竭的临床资料及复习相关文献。结果 48 h后患者意识障碍恢复,血肌酸激酶下降,酸中毒纠正,治疗效果显著。结论提高对HONK患者发生RM的认识和常规肌酶谱的动态监测,做好早期诊断以及预防极其重要,是RM合并急性肾损伤治疗的关键,有利于提高糖尿病患者的生存率。横纹肌溶解症的表现可能会被T1DM本身严重的病情掩盖而导致临床漏诊,故建议对T1DM患者应常规检测磷酸肌酸激酶以助诊断。Objective To report the clinical diagnosis and treatment experience of 1 case with acute renal failure caused by the hyperosmolar nonketotic diabetic coma with rhabdomyolysis in children. Methods The clinical data of 1 case with acute renal failure caused by the hyperosmolar nonketotic diabetic coma with rhabdomyolysis in children were analyzed and the related literatures were reviewed. Results The awareness of patients after 48 h recovered, and the blood creatine kinase decreased, and the acidosis was corrected, and the treatment effect was obvious. Conclusion It is vital to improve the HONK patients＇ awareness of RM and dynamic monitoring of routine muscle enzyme spectrum, and do well in the early diagnosis and prevention, and it is the key to the treatment of RM combined with acute renal injury, which is conducive to improving the survival rate of diabetes patients, and the manifestations of rhabdomyolysis can be covered by the serious disease of T1DM, therefore, it is suggested to conduct the routine test of phosphocreatine kinase of T1DM patients to help diagnosis.

关 键 词：型糖尿病 高渗性非酮症糖尿病昏迷 横纹肌溶解 急性肾功能衰竭 

分 类 号：R587.2[医药卫生—内分泌]