以胸痛首发的糖尿病酮症酸中毒一例并文献复习

发布时间：2018-05-31 15:03

本文选题：急性胸痛 + 糖尿病酮症酸中毒　；参考：《浙江大学》2017年硕士论文

【摘要】：目的:提高对急性胸痛患者的诊断与鉴别诊断能力,探讨糖尿病酮症酸中毒引发胸痛的可能机制。方法:报道一例以胸痛为首发症状的糖尿病酮症酸中毒病例,并进行文献回顾与分析讨论,并做简单综述。结果:患者首发症状不典型,检验检查排除其他胸痛病因,糖尿病酮症酸中毒诊断明确,经补液降糖纠正酸碱平衡等治疗后胸痛缓解,酮症酸中毒纠正,血糖平稳,出院后3个月随访期间血糖控制平稳,无类似急性胸痛发作。复习文献与糖尿病酮症酸中毒相关的胸痛机制可能与应急状态下的心脏病变相关,如应激性心肌病及糖尿病心脏病等结论:急性胸痛的罕见病因可以是糖尿病酮症酸中毒,糖尿病酮症酸中毒患者发生的急性胸痛易于其他胸痛表现疾病发生误诊,其机制可能与糖尿病酮症应激状态下的心脏损伤相关。因此综合分析胸痛病因,重视急性胸痛的鉴别诊断,同时加强对糖尿病酮症酸中毒不典型临床表现的认识,在急诊诊断及治疗中十分重要。
[Abstract]:Objective: to improve the ability of diagnosis and differential diagnosis in patients with acute chest pain and to explore the possible mechanism of chest pain caused by diabetic ketoacidosis. Methods: a case of diabetic ketoacidosis with chest pain as the first symptom was reported. Results: the initial symptoms of the patients were atypical, other causes of chest pain were excluded, the diagnosis of diabetic ketoacidosis was clear, the chest pain was alleviated after resuscitation, the correction of ketoacidosis was achieved, and the blood sugar was stable. After 3 months of discharge, blood glucose control was stable, no similar acute chest pain attack. The mechanism of chest pain associated with diabetic ketoacidosis may be associated with heart disease in emergency state, such as stress cardiomyopathy and diabetic heart disease. Conclusion: the rare cause of acute chest pain may be diabetic ketoacidosis. The acute chest pain in patients with diabetic ketoacidosis is prone to misdiagnosis of other chest pain manifestations, and its mechanism may be related to the heart damage caused by diabetic ketoacidosis stress. Therefore, it is very important to analyze the etiology of chest pain, pay attention to the differential diagnosis of acute chest pain and strengthen the understanding of atypical clinical manifestations of diabetic ketoacidosis in emergency diagnosis and treatment.
【学位授予单位】：浙江大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R587.2

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