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本文报告肾小管酸中毒7例,结合国内外献报告的28例,着讨论了临床分型、诊断和鉴别诊断问题。根据临床表现,作者将肾小管酸中毒分为三种临床类型:(一) 低血钙骨软化型,成人主要表现为骨痛,儿童表现为发育障碍。并提出了此型与维生素D不足引起的骨软化的鉴别要点。肾小管酸中毒尿钙尿磷常增多,治疗后显著减少;单纯用维生素D治疗,即使大剂量亦难奏效,而单独用碱性药物纠正酸中毒,却可治愈骨软化;血偏酸与尿偏碱。(二) 低血钾型,主要表现为神经骨骼肌的症状群,即肌肉软弱无力,甚至软瘫,周
This article reports 7 cases of renal tubular acidosis, combined with domestic and foreign reports presented 28 cases, discusses the clinical classification, diagnosis and differential diagnosis. According to clinical manifestations, the authors classified renal tubular acidosis into three clinical types: (i) hypocalceosal osteomalacia, which predominantly manifested as bone pain in adults and dysplasia in children. And made this type and vitamin D deficiency caused by osteomalacia identification points. Renal tubular acidosis often increased urinary calcium and urinary phosphorus, significantly reduced after treatment; simply with vitamin D treatment, even if high doses are difficult to work, and alone with alkaline drugs to correct acidosis, but can cure osteomalacia; blood acid and urine Alkaline. (B) hypokalemia, mainly for the symptoms of nervous skeletal muscle groups, that muscle weakness, or even soft paralysis, weeks