SARS-CoV-2感染后诱发暴发性1型糖尿病合并多器官损害一例  

Fulminant type 1 diabetes mellitus with multiple organ damage after SARS-CoV-2 infection:A case report

作　　者：吴丽滢 陈广树 熊晓清 冉建民 Wu Liying;Chen Guangshu;Xiong Xiaoqing;Ran Jianmin(Department of Endocrinology,The Fourth Affiliated Hospital of Jinan University Medical School,Guangzhou 510220,China)

机构地区：[1]暨南大学附属广州红十字会医院内分泌科,广州510220

出　　处：《中华临床医师杂志（电子版）》2024年第1期109-112,共4页Chinese Journal of Clinicians(Electronic Edition)

摘　　要：暴发性1型糖尿病(FT1DM)的特征是胰岛细胞发生了快速、不可逆的破坏,迅速出现糖尿病酮症酸中毒(DKA)。近2周内病毒感染与其发病密切相关。本文报道一例青年男性患者在罹患COVID-19后近2周出现糖尿病酮症酸中毒。该患者既往无糖尿病史,以重症DKA起病,合并病毒性心肌炎、重症肺炎、急性肾功能衰竭。入院后予以连续性血液净化(CRRT)、机械通气、大量补液和静脉胰岛素应用,纠正电解质及酸碱平衡紊乱、营养心肌等积极处理。患者血糖控制良好、DKA纠正,生命体征及内环境渐趋稳定。出院后继续予胰岛素强化治疗。提示:SARS-CoV-2感染后可能诱发FT1DM,且易合并多器官功能损害,病情危重、预后差。应及时多学科联合救治以提高生存率。Fulminant type 1 diabetes mellitus(FT1DM)is characterized by rapid and irreversible destruction of islet cells and rapid development of diabetic ketoacidosis(DKA).Viral infection within two weeks is closely associated with its onset.This paper reports a case of a young male patient who developed DKA almost 2 weeks after SARS-CoV-2 infection.The patient had no history of diabetes,and he developed severe DKA,combined with viral myocarditis,severe pneumonia,and acute renal failure.After admission to the hospital for continuous renal replacement therapy(CRRT),mechanical ventilation,supplementation of large amounts of fluid and intravenous insulin application,correction of electrolyte and acid-base balance disorders,nourishment of the heart muscle,and other active treatments,the patient’s blood sugar was well controlled,DKA was corrected,and vital signs and the internal environment gradually stabilized.Insulin-enhanced therapy continued after hospitalization.The present case suggests that FT1DM may develop after SARS-CoV-2 infection,and is prone to combined multi-organ impairment,severe disease,and poor prognosis.Timely multi-disciplinary joint intervention can improve survival.

关 键 词：暴发性1型糖尿病 COVID-19 SARS-CoV-2 多器官损害 多学科联合救治 

分 类 号：R587.2[医药卫生—内分泌]