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題名 | Milk-Alkali Syndrome Caused by Chewing Betel Nuts=嚼檳榔引起的牛奶鹼症候群 |
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作者姓名(中文) | 楊久滕; 何鎧任; 吳家兆; 楊松昇; 莊繼光; 林石化; | 書刊名 | 醫學研究 |
卷期 | 20:8 2000.10[民89.10] |
頁次 | 頁429-434 |
分類號 | 415.596 |
關鍵詞 | 檳榔; 牛奶鹼症候群; Betel nut; Milk-alkali syndrome; |
語文 | 英文(English) |
中文摘要 | 以代謝性鹼中毒、高血鈣症及腎衰竭為特徵之牛奶鹼症候群(milk-alkali syndrome)已於消化性潰瘍接受大量鈣及可吸收鹼來緩解症狀之患者被報導過。我們所描述的是一位罹患倦怠、食慾差、體重減輕、便秘約兩週之六十歲男性。他有嚼食沾有含碳酸鈣之牡蠣殼膏及樹葉包裹之檳榔每日約40至60粒以增強體力的習慣約40年。身體檢查發現細胞外液體液缺乏。實驗室檢查發現代謝性鹼中毒(PH: 7.46, PCO₂: 50.8 mmHg, PO₂: 76.4 mmHg, HCO₃: 35.6 Meq/L)、高血鈣症(12.8 mg/dL)及腎衰竭(血液尿素氮37 mg/dL,肌酸酐9.3 mg/dL)。血清中副甲狀腺激素(intact-parathyroid hormone, 2.7 pg/mL)及活化維生素D (1, 25-dihydroxycholecalciferol, 8.2 pg/mL)濃度皆因高血鈣而適當降低。所以代謝異常皆於一週內接受支持療法及戒掉檳榔後矯正回正常,但腎功能仍呈現異常。因為嚼檳榔在臺灣相當流行,故執業醫師必須於患者有嚼檳榔時,知悉有此一可逆性症候群之可能性。 |
英文摘要 | Milk-alkali syndrome characterized by the triad of metabolic alkalosis, hypercalcemia and renal failure has been reported in patients with peptic ulcer disease who ingest large amounts of calcium and absorbable alkali for relief of symptoms. We describe a 60-year-old male who suffered from lethargy, poor appetite, body weight loss and constipation for 2 weeks. He had the history of chewing betel nuts wrapped in oyster shell pastes containing calcium carbonate 40-60 serves daily for enhancing physical activity for 40 years. Physical examination revealed extracellular volume depletion. Laboratory investigations displayed metabolic alkalosis with pH 7.46, PCO₂ 50.8 mmHg, PO₂ 76.4 mmHg, and HCO₃ 35.6 mEq/L, renal failure with creatinine 9.3 mg/dL and blood urea nitrogen 37 mg/dL, and hypercalcemia 12.8 mg/dL. Serum intact-parathyroid hormone (2.7 pg/mL) and 1,25-dihydroxycholecalciferol levels (8.2 pg/mL) were appropriately decreased in response to hypercalcemia. All metabolic abnormalities were corrected in one week whereas renal function was still impaired after appropriate supportive measures and cessation of betel nut ingestion. Since betel nut chewing is popularly consumed in Taiwan, the practicing physician should be aware of the possibility of this reversible syndrome when betel nuts were used by the patient. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。