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1 病例报告 例1:女,13岁。因烦渴多尿1月.恶心、呕吐2天急诊入院.6年前诊断为肾病综合征,多次住院持续应用强的松(10~60mg/d)治疗。2月前第7次住院.考虑肾病再次复发.即将强的松60mg/d增至120mg/d.增量前连续4次尿糖检查(-),增量第10天.血压由16/11kPa增至24/16kPa.即将强的松减量为90mg/d.病情稳定出院治疗.出院后强的松逐渐减量至70mg/d,多饮多尿日趋明显.每日饮水量3000ml以上,近两天频繁呕吐,精神萎靡,再次住院.体检:神萎、懒言、柯兴氏面容、皮肤干、粗,血压18/11kPa.心音低钝,腹部紫纹征,四肢消瘦。尿检:蛋白:(-),酮体(+++),尿糖(++++);血糖20mmol/L,CO_2 CP 15.96mmol/L,K~+3mmo1/L,Na~+126mmol/L,Cl~-90mmol/L.诊断为类固醇糖尿病,酮症酸中毒.给予纠正水.电解质紊乱,同时给胰岛素50u/d.逐减强的松剂量.强的松减至40mg/d.尿糖持续(+++).住院37天出院.出院后随着强的松减量胰岛素逐渐减量至停药.出院45天
1 Case Report Example 1: Female, 13 years old. Due to polydipsia and urination in January.Nausea and vomiting 2 days emergency hospital admission.Diagnosis of nephrotic syndrome 6 years ago, multiple hospitalizations continued application of prednisone (10 ~ 60mg / d) treatment. 2 months before the hospitalization of 7. Considered kidney disease relapse. That is, prednisone 60mg / d increased to 120mg / d. Increment before 4 consecutive urine tests (-), incremental day 10. Blood pressure by 16 / 11kPa To 24 / 16kPa. About the amount of prednisone to 90mg / d. Discharge was stable. Discharge prednisone gradually reduced to 70mg / d, polydipsia polyuria increasingly evident. Daily drinking water more than 3000ml, near Two days of frequent vomiting, apathetic, hospitalized again Physical examination: Shen Wei, lazy words, Cushing’s face, dry skin, rough, blood pressure 18 / 11kPa. Heart sound low blunt, abdominal purple mark, limbs weight loss. Urine test: Protein: (-), ketone body (+++), urine sugar (++++); blood glucose 20mmol / L, CO_2 CP 15.96mmol / L, K ~ + 3mmo1 / L, Na ~ + 126mmol / L , Cl ~ -90mmol / L. Diagnosis of steroid diabetes, ketoacidosis given to correct water. Electrolyte disorders, while giving insulin 50u / d by the reduced dose of prednisone reduced to 40mg / d. Continuous (+++). Hospitalized 37 days after discharge from the hospital with the dose of prednisone tapering to withdrawal. Discharged 45 days