胃轻瘫合并肾糖阈减低致反复糖尿病酮症一例报道  

Recurrent diabetic ketosis induced by gastroparesis and reduced renal threshold for glucose excretion:a case report

作　　者：乐云逸 刘烨[1] 王海宁[1] 洪天配[1] 高洪伟[1] LE Yunyi;LIU Ye;WANG Haining;GAO Hongwei(Department of Endocrinology,Peking University Third Hospital,Beijing 100191,China)

机构地区：[1]北京大学第三医院内分泌科,100191

出　　处：《中国糖尿病杂志》2020年第10期779-782,共4页Chinese Journal of Diabetes

摘　　要：报道1例BG控制达标、反复呕吐伴DM酮症的T2DM患者,经胃排空显像检查诊断为DM性胃轻瘫,尿糖测定提示肾脏排糖增多、肾糖阈减低。予促胃动力药物治疗,适度增加精细碳水化合物摄入以保证能量供应,消化道症状缓解,3个月后肾糖阈恢复正常,DM酮症随访2年未复发。反复恶心呕吐伴酮症DM患者需鉴别胃轻瘫,予促胃动力治疗的同时,保证能量供应。急性糖代谢紊乱可造成一过性肾糖阈下降,诱发酮症。We reported a patient with recurrent vomiting and diabetic ketosis under targeted glycemic lever.The diagnosis of diabetic gastroparesis was confirmed by gastric emptying scintigraphy.Urine glucose testing suggested reduced renal threshold.Gastrointestinal symptoms were relieved after treatment of gastro-prokinetic agents and proper carbohydrates intake to maintain the adequate energy supply.Renal threshold was recovered 3 months later and diabetic ketosis didn’t relapse during the 2 years follow-up.It suggested that gastroparesis should be considered in patients with recurrent nausea,vomiting and ketosis.Gastroprokinetic agents and proper energy supply are needed.In addition,metabolic disorder may also induce a decreased renal threshold for glucose excretion which may contribute to the recurrence of ketosis.

关 键 词：胃轻瘫 糖尿病酮症 糖尿病 2型 肾糖阈 

分 类 号：R587.2[医药卫生—内分泌]