36例药物诱发的糖尿病低血糖昏迷病因分析

Drug-induced hypoglycemia coma in 36 patients with diabetes

目的 探讨药物诱发的糖尿病低血糖昏迷及危险因素。方法 采用葡萄糖氧化酶法检测 3 6例昏迷时血糖。结果 3 6例糖尿病低血糖昏迷中 ,19例服用优降糖 ,占 5 2 8% ;6例服用达美康并降糖灵 ,占 16 7% ;5例使用胰岛素 ,占 13 9% ;6例使用胰岛素不当 ,占 16 7% ;3 6例中 ,年龄 60岁以上者 2 8例 ,占 77 8% ;肾功能不全 2 3例 ,其中同时存在食物摄取不足 6例 ,占 63 9% ;肝功能不全 4例 ,占 11 1% ;酗酒 2例 ,占 5 6%。磺脲类药物并服阿斯匹林 2例 ,占 5 6% ;并服心得安 1例 ,占2 8% ;并服磺胺甲基异口恶唑 -甲氧苄氨嘧啶 (SMZ -TMP) 1例 ,占 2 8%。严重感染 1例 ,占 2 8% ;剧烈运动 1例 ,占 2 8%。结论 糖尿病患者在使用降糖药治疗过程中 ,年龄老、肝肾功能不全、酗酒、食物摄取不足、并服阿斯匹林、SMZ -TMP和心得安 ,严重感染、剧烈运动等是低血糖昏迷的危险因子。

Objective To investigate drug induced hypoglycemia coma and risk factors in patients with diabetes. Method Blood glucose in 36 patients with hypoglycemia coma was measured with method of glucose oxydase. Results Among 36 patients with hypoglycemia coma, 19(52.8%) took glibenclamide; 6(16.7%) took gliclazide and phenformin; 5(13.9%) were injected with insulin; 6(16.7%)were injected with excessive insulin. Among 36 patients with hypoglycemia coma, 28(77.8%) were over 60 years old; 23(63.9%) were renal insufficiency; 4(11.1%) were hepatic insufficiency; 2(5.6%) were alcoholic; 2(5.6%)took aspirin as sulfonylurea agent; 1(2.8%) took propranolol as well as well as sulfonylurea agent; 1(2.8%) took SMZ-TMP as well as sulfonylurea agent; 1(2.8%) case had serious infection; 1(2.8%) had excessive sport. Conclusion When the patients with diabetes are treated with hypoglycemic agents, the old age, renal and hepatic insufficiency, excessive drinking, poor ingestion, aspirin, propranolol, SMZ-TMP, serious infection, excessive sport and so on are the risk factors for hypoglycemia coma.