查詢結果分析
來源資料
頁籤選單縮合
題 名 | 持續代謝性酸中毒--糖尿病酮酸中毒合併隱藏性甲狀腺毒血症=Prolonged Metabolic Acidosis--Thyroid Storm Masked by Diabetic Ketoacidosis |
---|---|
作 者 | 張冠群; 廖為博; 余麗嬌; | 書刊名 | 內科學誌 |
卷 期 | 13:5 2002.10[民91.10] |
頁 次 | 頁263-266 |
分類號 | 415.593 |
關鍵詞 | 糖尿病酮酸中毒; 甲狀腺毒血症; 甲狀腺風暴; Diabetic ketoacidosis; Thyrotoxicosis; Thyroid storm; |
語 文 | 中文(Chinese) |
中文摘要 | 糖尿病酮酸中毒(DKA)和甲狀腺風暴(Thyroid storm)二者均為內科急症,需要及時的診斷及予以適當的治療,方能避免不幸的後果。我們報告一例胰島素依賴型糖尿病(IDDM)女性,因糖尿病酮酸中毒入院,病人從無甲狀腺疾病史和體徵如甲狀腺腫大、眼病變等;在治療DKA過程中,因心搏過速、病程進展緩慢及持續酮酸中毒,因而發現甲狀腺機能亢進,且符合甲狀腺風暴診斷。經適當治療後,病況迅速緩解。在糖尿病併發甲亢症時,極易造成高酮血症,且甲狀腺風暴常見的特徵一發燒,在DKA之下並不一定出現;僅以非特異性的心搏過速來診斷,較為困難。DKA病患無故的持續性酸中毒及病程延長,必須考慮有隱藏性甲狀腺機能亢進或風暴的可能。 |
英文摘要 | Hyperthyroidism may aggravate the glycemic control of diabetic patients and the glucose intolerance of non-diabetic patients. Thyrotoxicosis may increase the tendency to ketosis, which is a precipitating factor of diabetic ketoacidosis (DKA). We reported a 32 years old female patient without the history and physical signs of thyroid disease, who had unusually prolonged metabolic acidosis and persistent vomiting during the treatment of DKA. Because of the persisted tachycardia and prolonged course of DKA treatment, we started to check the probabi-lity of thyrotoxicosis. According to the criteria of Burch and Wartofsky for thyroid storm, we made diagnosis of thyroid storm and the patient was treated promptly resulting in dramatic improvement. We suggest that if patients with tachycardia and prolonged acidosis, thyroid storm should be first considered even no history or signs of thyroid disease during the treatment of DKA. Besides, fever is not the cardinal finding of the thyroid storm with DKA. |
本系統中英文摘要資訊取自各篇刊載內容。