患者女性,66岁,患糖尿病充血性心力衰竭。因多饮多尿和迅速出现嗜睡、意识混乱,无腹泻,发热或头部创伤史。否认饮酒、口服硷性水杨酸等毒物。正在服用的药物NPN胰岛素10单位每晨一次,metolazone2.5mg每日二次,速尿40mg/日、地戈辛0125mg/日。怀疑二周来病人非故意地增加利尿剂治疗。入院时病人对语言刺激反应很小, Female patient, 66 years old, suffering from congestive heart failure with diabetes. Because of polyhydramnios and rapid drowsiness, confusion, no diarrhea, fever or head trauma history. Denied drinking, oral salicylic acid and other toxic substances. NPN insulin 10 units being taken once per morning, metolazone 2.5 mg twice daily, furosemide 40 mg / day, digoxin 0125 mg / day. It is suspected that the patient unintentionally increased diuretic treatment in two weeks. The patient’s reaction to the language stimulus was minimal at admission,