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肾小管酸中毒(RTA)临床表现复杂多样,常易误诊,现将我科近年来收治的三例报告如下。病例报告例一,雷某,女性,58岁。因全身骨、关节痛、乏力,有时不能行走。有多饮、多尿,嗜咸食,偶有呕吐三年。体格检查:指关节呈对称性梭状畸形,僵直,指间肌萎缩。心肺检查阴性。没有肾区叩击痛,下肢未见浮肿。诊断为类风湿性关节炎而入院。实验室检查:尿常规阴性,尿糖阴性,尿pH6～7,尿量1500～3000ml/24小时,尿比重1.002～1.006,尿钾1.2g/24小时,尿17-酮类固醇(17—ks)5.2mg/24小时,17-羟类固醇(17-OHCS)3.8mg/24小时。二氧化碳结合力(CO_2-CP)24.04容积％,血钾12mg/dL,血钠310mg/dL,血钙6.9mg/dL,氯化物680mg/dL。NPN 30mg/dL,
Renal tubular acidosis (RTA) clinical manifestations of complex and diverse, often misdiagnosed, now my department admitted in recent years, three cases are reported as follows. Case report one, Lei Mou, female, 58 years old. Due to systemic bone, joint pain, fatigue, and sometimes can not walk. How to drink, polyuria, addicted to salt, occasionally vomiting for three years. Physical examination: The knuckles were symmetrical fusiform deformities, stiff, inter-finger muscle atrophy. Cardiopulmonary examination negative. No perineural area percussion pain, no swelling of lower limbs. Diagnosis of rheumatoid arthritis and admission. Laboratory tests: urine negative, urine negative, urine pH6 ~ 7, urine output 1500 ~ 3000ml / 24 hours, urine specific gravity 1.002 ~ 1.006, urinary potassium 1.2g / 24 hours, urine 17- ketosteroid (17-ks) 5.2 mg / 24 hours, 17-hydroxysteroid (17-OHCS) 3.8 mg / 24 hours. 24.04% CO 2 -CP, 12 mg / dL potassium, 310 mg / dL sodium, 6.9 mg / dL calcium and 680 mg / dL chloride. NPN 30 mg / dL,