以脑功能障碍为主的低血糖症73例临床分析

目的 探讨以脑功能障碍为主要表现的低血糖症的临床特点及发病机制。方法 回顾分析73例低血糖反应致脑功能障碍的临床资料。结果 糖尿病降糖治疗药物剂量调控不佳是造成该症的主要原因,临床主要表现为昏迷、偏瘫、癫痫、精神异常等,其发病机制复杂,可能和血糖下降速度快、病人年龄大、存在脑动脉硬化以及低血糖引起脑血管痉挛或神经的选择性损伤等因素有关。结论 凡遇诊断未明的脑功能障碍者应常规检查血糖,以尽快确诊治疗。此外,糖尿病病人合理使用降糖药物、定期监测血糖是预防低血糖症的关键。

Clinical analysis of 73 cases of hypoglycemia with brain dysfunctions

Objective To identify the clinical features and pathogenesis of hypoglycemia with brain dysfunctions as the main manifestations. Method A retrospective analysis of 73 cases with brain dysfunctions caused by hypoglycemia was performed. Result Hypoglycemic brain dysfunctions were mainly caused by poor control of the dosage of hypoglycemic agents in diabetic patients, and the major clinical manifestations included coma, hemiparalysis, epilepsy and mental disorders. The pathogenesis was complicated, possibly related to a variety of factors such as rapid declination of blood sugar level, aging, cerebral arteriosclerosis, and hypoglycemic cerebral vasospasm or selective nerve injury. Conclusions A blood sugar test should be performed for any patients with brain dysfunctions of unidentified causes for early diagnosis and treatment. In addition, diabetic patients should take hypoglycemic agent adequately. Regular monitoring of blood sugar level is key to the prevention of hypoglycemia.