Bohannon N J
St Luke's Hospital, San Francisco, Calif.
Arch Intern Med. 1989 Jun;149(6):1423-5.
Although hypophosphatemia is known to commonly accompany therapy for hyperglycemia, it is not generally appreciated that severe life-threatening depletion of phosphate may occur. I followed up two patients who had precipitous drops during intravenous insulin therapy for diabetic ketoacidosis and hyperosmolar nonketotic state. The patient with diabetic ketoacidosis had a phosphate level nadir that equaled the lowest recorded phosphate level in a living human (0.03 mmol/L). Because (1) serum phosphate levels do not reflect total body phosphate stores, (2) rapid shifts of phosphorus can occur among body compartments, and (3) severe hypophosphatemia is potentially life-threatening, phosphate levels should be frequently monitored during therapy for hyperglycemia and intervention should be undertaken if phosphate levels fall below 0.5 mmol/L.
虽然已知低磷血症常伴随高血糖治疗出现，但严重的、危及生命的磷酸盐耗竭情况却未得到普遍重视。我随访了两名在糖尿病酮症酸中毒和高渗性非酮症状态的静脉胰岛素治疗期间出现磷酸盐急剧下降的患者。患有糖尿病酮症酸中毒的患者磷酸盐水平最低点等于有记录以来活人最低的磷酸盐水平（0.03 mmol/L）。由于（1）血清磷酸盐水平不能反映全身磷酸盐储备，（2）磷可在身体各腔室间快速转移，以及（3）严重低磷血症可能危及生命，因此在高血糖治疗期间应频繁监测磷酸盐水平，若磷酸盐水平低于0.5 mmol/L则应进行干预。
