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患者,男,73岁。患糖尿病20年,浮肿8个月,长期口服甲磺吡脲,每次一片,每天两次。因突然意识模糊、烦燥及四肢湿冷在当地医院测血糖2.4mmol/L,拟低血糖症经静注及静滴葡萄糖后清醒转送我院。体检:T38℃,R20次/分,BP26/12kPa。嗜睡,面部浮肿,四肢湿冷。心率104次/分,律整。双肺中小水泡音。肝脾未扪及。下肢凹陷性浮肿。实验室检查:血糖1.87mmol/L,BUN26.8mmol/L,CO_2CP12.6mmol/L,Cr.1242umol/L,血清钾、钠及氯正常。WBC18.5×10~9/L,RBC2.9×10~(12)/L。尿蛋白++。胸片:双肺片状阴影。诊断:甲磺吡脲致低血糖症;糖尿病肾病,慢性肾功能不全,尿毒症期;肺部感染。经10％葡萄糖静滴
Patient, male, 73 years old. 20 years suffering from diabetes, edema for 8 months, long-term oral metsulfuride, one each time, twice daily. Because of sudden confusion, irritability and limbs cold in the local hospital measured blood glucose 2.4mmol / L, hypoglycemia by intravenous and intravenous infusion of glucose after awake sent to our hospital. Physical examination: T38 ℃, R20 beats / min, BP26 / 12kPa. Lethargy, facial swelling, cold and limbs. Heart rate 104 beats / min, law and order. Small and middle ear blisters sound. Liver and spleen not palpable. Sagging depression edema. Laboratory tests: blood glucose 1.87mmol / L, BUN26.8mmol / L, CO_2CP12.6mmol / L, Cr1242umol / L, serum potassium, sodium and chlorine normal. WBC18.5 × 10 ~ 9 / L, RBC2.9 × 10 ~ (12) / L. Urinary protein ++. Chest radiograph: bilateral lung shadow. Diagnosis: Metopulgin-induced hypoglycemia; diabetic nephropathy, chronic renal insufficiency, uremia; pulmonary infection. After 10% glucose intravenous infusion