严重高血糖的老年糖尿病非酮症高渗性昏迷22例临床分析

Analysis of diabetic nonketotic hyperosmolar coma with severely hyperglycemia in senile:a report of 22 cases

目的探讨严重高血糖的老年糖尿病非酮症高渗性昏迷的临床特点。方法回顾分析一组血糖在70mmol/L以上的老年糖尿病非酮症高渗性昏迷病历情况,并与血糖在33.3-55.5mmol/L的老年糖尿病非酮症高渗性昏迷对照,比较两组治疗后的血糖变化、胰岛素用量及病死率等。结果观察组治疗48h后血糖下降无显著性(P>0.05),平均每日胰岛素用量为(780±38)u,对照组为(162±12)u,P<0.01,病死率为86.4%(对照组为25.7%,P<0.01)。结论入院时血糖严重升高的老年糖尿病非酮症高渗性昏迷患者治疗难度大,预后差,病死率高。

[Objective] To assess the clinical features of diabetic nonketotic hyperosmolar coma with severely hyperglycemia in senile.[Methods] The charts of 22 senile diabetic nonketotic hyperosmolar coma with blood glucose value up to 70 mmol/L were reviewed and those of 35 senile diabetic nonketotic hyperosmolar coma with blood glucose value between 33.3～55.5 mmol/L were regarded as control,then to compare the variations of blood glucose,insulin dose and death rate after treatment on two groups.[Results] After 48 hours treatment on observe group there were no significantly differences in drop of blood glucose（P 〉0.05）,the average daily insulin dose was（780±38）u（162±12）u on control group,P 〈0.01,and death rate was 86.4%（25.7% on control group,P 〈0.01）.[Conclusion] It is suggested that the larger treatment difficulty,worse prediction and higher death rate occur on the senile diabetic nonketotic hyperosmolar coma with severely hyperglycemia at time of admission.