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患儿,男,6岁。于2年前不明原因行走困难,双下肢无力并疼痛,逐渐呈瘫痪状态。近一年伴多饮、多尿。在外院诊为“婴儿瘫”。来院体检:发育营养差,身高81cm,体重11kg,可见典型佝偻病体征,呼吸促,双肺可闻及湿性罗音。腹膨隆,肝肋下3cm,脾未触及,四肢肌张力低下,肌力Ⅲ°,膝反射未引出。实验室检查:尿蛋白(一),尿P~H8.5,比重1.008,尿糖(一)。血钾2.1mmol/L,血钙2.17mmol/L,血氯化物118mmol/L,血磷0.711mmol/L,CO_2—CP10.7mmol/L,碱性磷酸酶188金氏单
Children, male, 6 years old. Difficult to walk two years ago, unexplained, weakness and pain in both lower extremities, and gradually paralyzed. Nearly a year with more drinks, more urine. Outside the hospital diagnosed as “baby paralysis.” To the hospital physical examination: poor developmental nutrition, height 81cm, weight 11kg, showing typical signs of rickets, shortness of breath, lungs can be heard and wet rales. Abdominal distension, liver ribs 3cm, spleen not touched, limb muscle tension is low, muscle strength Ⅲ °, knee reflex did not lead. Laboratory tests: urinary protein (a), urine P ~ H8.5, the proportion of 1.008, urine sugar (a). Blood potassium 2.1mmol / L, blood calcium 2.17mmol / L, blood chloride 118mmol / L, phosphorus 0.711mmol / L, CO_2-CP10.7mmol / L, alkaline phosphatase 188 Kim single