作者：王绮，高冠起，杜文华，王宪丽

单位：

1.264003山东省烟台市，滨州医学院第二临床医学院2.276000山东省临沂市人民医院内分泌科　3.261053山东省潍坊市，潍坊医学院

Units：

1.Second Clinical Medical College of Binzhou Medical College, Yantai 264003, China2.Department of Endocrinology, Linyi People's Hospital, Linyi 276000, China3.Weifang Medical College, Weifang 261053, China

关键词：

韦尼克脑病；高血糖高渗性非酮性昏迷；高渗高血糖综合征；硫胺素；病例报告

Keywords：

Wernicke's encephalopathy; Hyperglycemic hyperosmolar nonketotic coma; Hyperosmolar hyperglycemicsyndrome; Thiamine; Case reports

CLC：

R 746.4 R 587.2

DOI：

10.12114/j.issn.1008-5971.2023.00.185

Funds：

摘要：

韦尼克脑病（WE）是临床上罕见的代谢性脑病，其起病隐匿，临床表现多样，鉴别诊断困难。高渗高血糖综合征（HHS）合并非酒精性WE鲜有报道，两种疾病症状和体征重叠，使WE的鉴别诊断更加困难，更易漏诊。本文报道1例HHS合并非酒精性WE患者的诊疗经过，经WE诊断性治疗——硫胺素肌肉注射后患者精神状态明显好转，愈后良好。本文同时通过查阅相关文献，总结WE的临床特征、影像学表现、治疗及预后，以提高临床医生对此病的认识，降低WE的漏诊率。

Abstract：

Wernicke's encephalopathy (WE) is a rare metabolic encephalopathy in clinical practice, with insidiousonset, diverse clinical manifestations, and difficult differentiation. There are few reports of hyperosmolar hyperglycemic syndrome(HHS) combined with non-alcoholic WE, the overlapping symptoms and signs of the two diseases make it more difficult todistinguish WE and make it easier to miss diagnosis. This paper reports the diagnosis and treatment of a patient with HHScombined with non-alcoholic WE. After WE diagnostic therapy——thiamine intramuscular injection, the patient's mental stateimproved significantly and recovered well. Meanwhile, this paper summarizes the clinical features, imaging manifestations,treatment, and prognosis of WE by reviewing the relevant literature, in order to improve clinical doctors' understanding of thisdisease, and reduce missed diagnosis rates.

ReferenceList：