耐火性高离子间隙代谢酸性化由于慢性服用青:一个案例报告
D A Lamabadusuriya1,2, A K Bopitiya3, A D N W Perera3
1Department of Medicine, General Sir John Kotelawala Defense University, Dehiwala-Mount Lavinia, Sri Lanka. dilusha.lamabadusuriya@kdu.ac.lk.
Journal of medical case reports
|October 7, 2025
概括
长期使用青可以导致代谢性酸性疾病. 这种罕见的病症,酸性酸性酸性酸性酸性酸性酸性酸性酸性酸性酸性酸性酸性酸性酸性酸性酸性酸性酸性酸性酸性酸性酸性酸性酸性酸性酸性酸性酸性酸性酸性酸性酸性酸性酸性酸性酸性酸性酸性酸性酸性酸性酸性酸性酸性酸性酸性酸性酸性酸性酸性酸性酸性酸性酸性酸性酸性酸性酸性酸性酸性酸性酸性酸性酸性酸性酸性酸性.
科学领域:
- 临床医学 临床医学
- 腎臟病學 (nephrology) 是一種醫學專業.
- 毒理学 毒理学 毒理学
背景情况:
- 代谢性酸症在重症患者中很常见.
- 高离子间隙代谢酸性化有典型和非典型的原因.
- 非典型的病因需要高度的临床怀疑才能诊断.
研究的目的:
- 报告一种高阴离子间隙代谢酸症的异常原因.
- 为了突出这种情况的特定治疗方法.
主要方法:
- 一个45岁的糖尿病女性的案例研究,呈现出严重的代谢酸症.
- 对于败血症和功能衰竭的初始治疗是无效的.
- 诊断得到了尿液中5-oxoproline水平升高的证实,这表明由于慢性服用类醇而导致的类酸性化.
主要成果:
- 患者出现了Kussmaul呼吸和严重的代谢酸性疾病.
- 败血症和功能衰竭的标准治疗不能解决酸性疾病.
- 在停止服用白醇并开始N-乙半氨酸治疗后,酸症迅速消失.
结论:
- 慢性治疗性青的使用是高阴离子间隙代谢酸化的新出现的原因.
- 这种状况,即高胺酸,是由于谷氨耗尽而产生的,并影响了玛-谷氨基循环.
- 临床医生应考虑这种可逆原因在长期服用类醇治疗的患者.
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