肾小管性酸中毒临床较少见,由于其临床表现复杂,故易误诊。本文分析4例误诊原因,以供同道参考。一、误诊为重症肌无力与周期性麻痹: 例1:女,43岁。因全身无力、头抬不起来、咳嗽无力、吞咽困难3天就诊于神经科。查体:眼底及颅神经(-),四肢肌张力降低,近端肌力Ⅱ°,远端肌力Ⅱ～Ⅲ°,感觉无异常。心电图示 Renal tubular acidosis is less common clinical, because of its complex clinical manifestations, it is easy to misdiagnosis. This article analyzes 4 cases of misdiagnosis reasons, for fellow reference. First, misdiagnosed as myasthenia gravis and periodic paralysis: Example 1: Female, 43 years old. Due to general weakness, head lift can not afford to cough, weakness, swallowing three days of treatment in neurology. Physical examination: fundus and cranial nerves (-), limb muscle tension decreased proximal muscle strength Ⅱ °, distal muscle strength Ⅱ ~ Ⅲ °, no abnormalities. ECG illustration