This 20-year-old female patient showed body weight declining for 2010-02-28, with mental tension and tiredness. She didn't have any treatment. Then she began to have cough, headache, thirst with desire to drink, nausea, vomiting, paraphasia, and confusion. After she was administered into our hospital, the laboratory tests showed that blood glucose > 33. 3 mmol/L, arterial blood gas of pH 6. 75, the blood sodium 122 mmol/L, blood potassium 6. 6 mmol/L, lactic acid 3. 9 mmol/L, and urine ketone ++. She was diagnosedas as fulminant T1DM (FID) , ketoacidosis, electrolyte disturbance, and hyperpotassemia and hyponatremia. With insulin treatment, liquid-supplementing, and liver-protecting, etc , the level of her blood glucose became stable, her liver function was restored, and her muscular enzymes became normal.%患者女,20岁,主因2010-02-28精神紧张及劳累后出现体重下降未予治疗后,又出现咳嗽、头痛、口干,多饮,伴头痛,恶心,呕吐、言语错乱,意识模糊等症状.患者入院后急查血糖,HI(血糖＞33.3 mmol/L).动脉血气分析:pH 6.75,血钠122 mmol/L,血钾6.6 mmol/L,乳酸3.9 mmol/L,尿酮(++).诊断为暴发性1型糖尿病(F1D),酮症酸中毒,电解质紊乱,高钾低钠血症.经胰岛素治疗控制血糖,积极补液降糖降酶,同时保肝等治疗2周后患者血糖平稳,肝功能基本恢复正常经治疗后,血糖控制平稳,肌酶正常.
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