克林霉素致昏迷

1例53岁男性患者,因咽炎给予克林霉素600 mg溶入0.9%氯化钠注射液250 ml静脉滴注.滴注结束时,患者突然昏迷,呼之不应,呼吸12次/min,双侧瞳孔对光反射消失.给予吸氧、补液治疗1 h后仍呈深昏迷状态.分别给予甘露醇、呋塞米、纳洛酮、葛根素、奥扎格雷钠等静脉滴注,治疗约12 h患者清醒,治疗约15 h时突然出现狂躁,给予氟哌啶醇5 mg肌内注射.治疗约20 h患者精神状态基本恢复正常.     

阿卡波糖引起低血糖昏迷

1名82岁2型糖尿病男患者,用格列吡嗪5mg,3次/d,治疗1～2年。然后,患者停用格列吡嗪,改用阿卡波糖50mg,3次/d,并增加到100mg,3次/d。治疗3个月后,出现昏睡。实验室检查显示:血糖2.1mmol/L,ALT62U/L,AST55U/L。患者在静脉给予50%和10%葡萄糖注射液后逐渐清醒。停用阿卡波糖,改用复方α-酮酸片和水飞蓟宾。3个月后,实验室检查显示:空腹血糖6.2mmol/L,ALT30U/L,AST26U/L。     

Diabetic keto-acidotic (DKA) coma following olanzapine initiation in a previously euglycaemic woman and successful continued therapy with olanzapine

We report the case of a euglycaemic woman whose glucose control rapidly decompensated following olanzapine initiation leading to diabetic coma. Hyperglycaemia has been associated with chronic psychotic disorders and antipsychotics for many years. However, it is unusual to see such rapid and life-threatening changes associated with treatment. The case highlights that changes in antipsychotic treatment may be associated with large changes in glucose tolerance, and that it is possible to continue antipsychotic treatment with appropriate diabetic care.     

高原昏迷与脂质过氧化反应

本文于喀喇昆仑山海拔3700m地区对收治的22例高原昏迷患者在治疗前和治愈后分别检测了血Hb、RBC－SOD、LPO和VitC，并与初入高原的健康青年做对照。结果：高原昏迷患者治愈后RBC－SOD显著低于治疗前（P＜0．01），更低于对照组（P＜0．001）、治愈后LPO较治疗前无显著差异（P＞0．05），但显著高于对照组（P＜0．001）。治愈后VitC显著高于治疗前（P＜0．05），显著低于对照组（P＜0．001）。作者认为，高原昏迷的发生与急性缺氧引发的机体一系列自由基损伤关系十分密切。