重型病毒性肝炎并发低血糖临床分析

目的 探讨重型病毒性肝炎患者血糖低于正常值的临床特点及防治对策。方法 回顾性分析2002年6月至2004年4月住院重型病毒性肝炎患者空腹血糖，对其在治疗过程中的变化做动态分析。结果 92例重型病毒性肝炎患者，空腹血糖低于正常67例(72．8％)，其中死亡56例(68．7％)，与其他并发症并存的发生率较高。动态分析空腹血糖降低患者治疗过程中血糖变化有三种形式，空腹血糖持续多次减低患者死亡率亦较高。空腹血糖减低患者中，仅部分呈典型低血糖症表现，死亡率最高。结论 重型病毒性肝炎常并发空腹血糖减低者的死亡率高。在积极综合治疗后，持续多次空腹血糖减低患者死亡率较高。呈低血糖症患者死亡率最高。血糖减低的治疗需要采取综合措施，个体化原则。

Clinical analysis of hypoglycemia in patients with severe viral hepatitis

Objective To study the clinical features and the preventive measures for hypoglycemia in patients with severe viral hepatitis. Methods The blood glucose levels, mortality and complications were retrospectively studied in 92 patients with severe viral hepatitis from June 2002 to April 2004. Results Sixty-seven of 92(72.8%) patients had hypoglycemia and 56 of them died(68.7%). Through dynamic analysis of the fasting blood-glucose levels of patients with hypoglycemia under comprehensive treatment, three-types of changes were observed and the mortality, incidence of complication were higher in patients with continous hypoglycemia. Of 67 patients with hypoglycemia, hypoglycemic syndromes were observed in only 22 patients. Conclusion Hypoglycemia is a common complication in patients with severe viral hepatitis. Hypoglycemic sydrome is only obverved in part of them. Comprehensive measures are necessary and should be individualized.