病例报告

　　【摘要】患者女，20岁，主因2个月前精神紧张及劳累后出现体重下降未予治疗后，又出现咳嗽、头痛、口干，多饮，伴头痛，恶心，呕吐、言语错乱，意识模糊等症状。患者入院后急查血糖，HI(血糖高于33.3mmol/L)。动脉血气分析：pH 6.75，血钠122 mmol/L，血钾6.6 mmol/L，乳酸3.9 mmol/L，尿酮(++)。诊断为暴发型1型糖尿病(F1D)，酮症酸中毒，电解质紊乱，高钾低钠血症。经胰岛素治疗控制血糖，积极补液降糖降酶，同时保肝等治疗2周后患者血糖平稳，肝功能基本恢复正常经治疗后，血糖控制平稳，肌酶正常。

　　【关键词】1型糖尿病，暴发型;肝损伤

　　Report on one case of fulminant T1DM ketoacidosis accompanied with acute transient liver injury ZHANG Cai-ge, ZHANG Li-hui, WANG Rui-ying, et al. Department of Endocrinology, The Second Hospital of Hebei Medical University,

　　【Summary】 Two months ago, the body weight of this 20-year-old female patient was declining due to mental tension and tiredness, but she didn’t have any treatment. Then she began to have cough, headache, thirst with desire to drink, nausea, vomiting, paraphasia, and confusion. After she was administered into hospital, the laboratory tests showed that blood glucose > 33.3mmol/L, arterial blood gas analysis: pH 6.75, the blood sodium: 122 mmol/L, blood potassium: 6.6 mmol/L, lactic acid: 3.9 mmol/L, and urine ketone: ++. She was diagnosed fulminant T1DM (F1D), ketoacidosis, electrolyte disturbance, and hyperpotassemia and hyponatremia. With insulin treatment for controlling the blood glucose and liquid-supplementing, enzyme-reducing, and liver-protecting, etc., the level of her blood glucose became stable, her liver functions was restored, and her muscular enzymes became normal.

　　【Key words】 Diabetes mellitus, type 1 (T1DM); Fulminant; Liver injury