以急性脑损害为突出表现的老年人低血糖症30例分析

目的分析以急性脑损害为突出表现的老年人低血糖症的临床特点。方法回顾性分析30例75岁以上老年人低血糖症的临床资料。结果30例中23例低血糖发生在早晨或黎明时，诱发因素为进食量少，使用降糖药后没有进行有效的血糖监测，降糖药服用后及皮下注射胰岛素后未及时进食或药物使用过量。发病时血糖浓度为0．8～2．8mmol／L。常以意识模糊、癫痫、肢体瘫痪、昏睡、昏迷等急性脑损害为突出表现。经及时补充葡萄糖液后脑损害迅速改善。28例低血糖经治疗后痊愈，2例死于多脏器功能衰竭。结论老年人低血糖发作常以急性脑损害为突出表现，交感神经兴奋症状轻微甚至缺乏。

Analysis of 30 case-times of elderly hypoglycemia mainly represented as acute brain damage

Objective To analyze the clinicall features of elderly hypoglycemia mainly represented as acute brain damage. Methods The clinical date of 30 case-times of hypoglycemia in patients older than 75 years were ret- rospectively analyzed. Results Hypoglycemia occurred at night or early morning in 23 cases. The causes of hypoglycemia included less food intake, lack of effective blood glucose monitoring affter use of hypoglycemia agents, no timely eating after taking medication and subcutaneous injections of insulin or excessive use of drugs. The patients blood sug- ar levels ranged between 0. 8 and 2. 8 mmol/L. The main clinical manifestations were acute brain damage, including confusion, epilepsy, hemiparesis, lethargy, coma and so on. After the prompt added glucose liquid brain damage rapidly improved. Twenty-eight cases were cured after therapy, 2 cases died of multiple organ failure. Conclusion The elderly hypoglycemia mainly represents as acute brain damage, with mild symptoms of sympathetic excitement or a lack of its symptoms.