Gitelman综合征合并骨质疏松症2例临床分析  

Clinical analysis of 2 cases of Gitelman syndrome combine osteoporosis

作　　者：邢清[1,2] 臧丽[1,2] 庞萍[2] 宋凌云 孙迪 韩松梅[2] 林家达 郭清华[1,2] XING Qing;ZANG Li;PANG Ping;SONG Lingyun;SUN Di;HAN Songmei;LIN Jiada;GUO Qinghua(Chinese PLA General Hospital,Beijing 100853,China;Hainan Branch Hospital,Chinese PLA General Hospital,Sanya,Hainan 572000,China)

机构地区：[1]解放军总医院,北京100853 [2]解放军总医院海南分院,海南三亚572000 [3]定安县人民医院,海南定安571200

出　　处：《中国热带医学》2018年第11期1162-1164,共3页China Tropical Medicine

基　　金：国家自然科学基金(No.81700679)

摘　　要：目的探讨2例Gitelman综合征合并骨质疏松症的临床特点、诊治经过,提高对Gitelman综合征的认识。方法以2例Gitelman综合征合并骨质疏松症患者为研究对象,分析临床资料,观察治疗反应和随访结果。结果 2例患者均为绝经早期女性,主要表现为正常血压伴低血钾、高尿钾、低血镁、低尿钙、代谢性碱中毒、骨质疏松,一例患者肾素-血管紧张素-醛固酮系统(renin-angiotensin-aldosterone system,RAAS)激活,一例患者RAAS未激活,两例患者均临床诊断为Gitelman综合征合并骨质疏松症。2例患者均给予口服氯化钾缓释片、门冬氨酸钾镁、安体舒通治疗,低血钾基本纠正,血镁接近正常低值;同时予抗骨质疏松治疗,预防脆性骨折发生。结论成年起病的Gitelman综合征,尤其是绝经早期女性患者,易合并骨质疏松症,临床应注意筛查并及时治疗。Objective To discuss the clinical characteristics and diagnostic program of Gitelman syndrome combine osteoporosis,and improve the diagnosis and treatment.Methods Two cases of Gitelman syndrome combine osteoporosis were observed.It was further confirmed by analyzing clinical data,observing therapeutic reaction and follow-up results.Results Two cases of Gitelman Syndrome were early menopause female.Main expression included hypokalemia,high urinary potassium,hypomagnesemia,hypocalciuria,metabolic alkalosis,osteoporosis with normal blood pressure.A case of RAAS was activated,but another was normal.The diagnosis of Gitelman syndrome combine osteoporosis was established.Two cases were treated by potassium chloride sustained-release tablet,potassium magnesium aspartate tablets and spironolactone,serum potassium was recovered to normal level and serum magnesium was closed to normal low value;while for preventing of brittle fracture,they were treated by antiosteoporosis drug.Conclusion We should pay more attention on screening osteoporosis from adult cases of Gitelman syndrome,especially early menopause female.In clinical practice,they should be treated in time.

关 键 词：GITELMAN综合征 低钾血症 低镁血症 骨质疏松症 

分 类 号：R596.1[医药卫生—内科学]