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我们近期诊治了1例上呼吸道感染并发肾小管性酸中毒的患者,笔者认为病例中出现的肾小管性酸中毒与病毒感染有密切的关系。现报告如下。患者,男,19岁,学生。1990年12月15日因突然双侧肢体活动障碍一天多,由其同学搀扶来我院就诊。患者七天前因鼻塞、咽干、咽痛而服用牛黄解毒丸两次后好转。但近一天半来患者觉双侧上下肢酸麻无力,活动障碍,直至不能行走和取物。五年来曾两次咽痛后引起类似发作。但无明显的家族史。体查:T37℃,P82次/分,R20次/分,BP13/7kPa,神清,咽充血,颈软,双肺听诊未闻异常,心音低钝,心律不整,每分钟可闻5～6次期前收缩,腹软,肝脾未触及。双上下肢肌力Ⅱ度,未引出病理神经反射和脑膜刺激征。实验室检查:血RBC,WBC及分类均正常,血沉和尿常规正常,抗“O”250单位,血钾1.68
We recently diagnosed a case of upper respiratory tract infection complicated by renal tubular acidosis patients, I think the case of renal tubular acidosis and viral infection are closely related. The report is as follows. Patient, male, 19 years old, student. December 15, 1990 due to sudden bilateral physical activity disorder more than a day, helped by their classmates to our hospital. Seven days ago due to nasal obstruction, throat, sore throat and taking bezoar detoxification pills after the two improved. But nearly a day and a half patients with both upper and lower limbs feel tingling, activity disorders, until they can not walk and take the goods. After five sore throats caused a similar episode in five years. But no obvious family history. Physical examination: T37 ℃, P82 times / min, R20 beats / min, BP13 / 7kPa, Shen Qing, pharyngeal congestion, neck soft, lung auscultation anomalies, low heart sound blunted, irregular heartbeat per minute can be heard 5 ~ 6 Contractions before the second period, abdominal soft, liver and spleen not touched. Double upper limb muscle strength Ⅱ, did not lead to pathological nerve reflex and meningeal irritation. Laboratory tests: blood RBC, WBC and classification were normal, ESR and normal urine, anti-“O” 250 units, potassium 1.68