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患者男,41岁。17年前无明显诱因出现耳闻人语被人陷害感,时有打人毁物、语无伦次,曾多次在精神病院住院诊断为精神分裂症。曾在我院治疗时单用氯丙嗪最大剂量达800 mg/d。住院半年病情好转出院,自服氯氮平300 mg/d维持半年。1周前症状复发,因冲动伤人而于2003年1月5日被强行入院。既往无糖尿病史,无其他器质性疾病史,无糖尿病家族史。入院查体：血压90/60 mm Hg,意识恍惚,问话不答,压眶反射引不出,两肺呼吸音清,心率130次/min,心音弱、无力。腹部触诊、神经反射均未见明显异常。实验室检查：血糖37．3 mmol/L,尿糖++++,尿酮体+++,血二氧化碳结合力10 mmol/L,血钾2．8 mmol/L,血
Patient male, 41 years old. 17 years ago there is no obvious incentive to hear the human language was framed, sometimes beaten, incoherent, have repeatedly diagnosed as schizophrenia in psychiatric hospital. Once treated with chlorpromazine alone in our hospital the maximum dose of 800 mg / d. Six months hospitalized condition improved discharge, self-service clozapine 300 mg / d maintained for six months. Symptoms recur after 1 week and were forcibly admitted on January 5, 2003 due to impulsive wounding. No past history of diabetes, no other organic disease history, no family history of diabetes. Admission examination: blood pressure 90/60 mm Hg, consciousness trance, ask not answer, pressure orbital reflex can not lead, lung breath sounds clear, heart rate 130 beats / min, weak heart, weakness. Abdominal palpation, reflex no obvious abnormalities. Laboratory tests: blood glucose 37.3 mmol / L, urine sugar ++++, urinary ketone body + + +, blood carbon dioxide binding 10 mmol / L, serum potassium 2.8 mmol / L, blood