Oosterheert J J, van de Wiel A
Ziekenhuis Eemland, afd. Interne Geneeskunde, Postbus 1502, 3800 BM Amersfoort.
Ned Tijdschr Geneeskd. 2002 May 18;146(20):950-4.
A 52-year-old man was admitted with diarrhea, near dehydration and dyspnoea. After many years of alcohol consumption, he had stopped drinking alcohol over a very short space of time and had eaten very little or nothing. He had tachypnoea, hypotension and an enlarged liver. Laboratory analysis revealed metabolic acidosis with an elevated anion gap, ketone bodies in the urine, increased free fatty acid levels and beta-hydroxybutyrate in the serum, fitting the picture of alcoholic ketoacidosis. The syndrome is explained by metabolic changes induced by chronic alcohol consumption and ketogenesis as the result of fasting and dehydration. Treatment consisted of correction of the fluid deficit and administration of glucose, after which the patient made a rapid recovery.
一名52岁男性因腹泻、接近脱水和呼吸困难入院。多年饮酒后,他在很短时间内戒酒,且进食极少或几乎未进食。他呼吸急促、血压低且肝脏肿大。实验室分析显示代谢性酸中毒伴阴离子间隙升高、尿中出现酮体、游离脂肪酸水平升高以及血清中β-羟基丁酸升高,符合酒精性酮症酸中毒的表现。该综合征可由长期饮酒引起的代谢变化以及禁食和脱水导致的酮体生成来解释。治疗包括纠正液体不足和给予葡萄糖,此后患者迅速康复。