Vukmir R B, Paris P M, Yealy D M
Affiliated Residency in Emergency Medicine, University of Pittsburgh, Pennsylvania 15213.
Ann Emerg Med. 1991 Apr;20(4):375-9. doi: 10.1016/s0196-0644(05)81658-0.
This study evaluated the efficacy of glucagon for prehospital therapy of hypoglycemia in patients without IV access.
Prospective clinical trial.
Prehospital in a busy, urban emergency medical services system.
Fifty consecutive patients presenting with documented hypoglycemia (ChemStrip BG less than or equal to 80 mg/dL) and symptoms of decreased level of consciousness, syncope, or seizure were enrolled.
Data collected included pretreatment (ChemStrip BG) and post-treatment serum glucose (hospital assay) as well as assessment of level of consciousness by a quantitative measure, the Glasgow Coma Score, and by a qualitative scale (0 to 3). The mean pretreatment blood glucose of 33.2 +/- 23.3 mg/dL increased after treatment to 133.3 +/- 57.3 mg/dL. Qualitative level of consciousness increased from a mean of 1.26 +/- .96 to 2.42 +/- .94 and Glasgow Coma Score increased from a mean of 9.0 +/- 4.19 to 13.04 +/- 3.68. The mean time until response was 8.8 minutes in those who responded to both level of consciousness criteria 82% (41 of 50). Glucagon administered for hypoglycemia resulted in a glucose increase in 98% (49 of 50) with headache as the only side effect noted in 4% (two of 50) of patients (P less than .0001).
Glucagon is safe and effective therapy for hypoglycemia in the prehospital setting.
本研究评估了胰高血糖素在无静脉通路患者院前低血糖治疗中的疗效。
前瞻性临床试验。
繁忙城市紧急医疗服务系统的院前环境。
连续纳入50例有低血糖记录（化学试纸血糖小于或等于80mg/dL）且伴有意识水平下降、晕厥或癫痫症状的患者。
收集的数据包括治疗前（化学试纸血糖）和治疗后血清葡萄糖（医院检测），以及通过定量指标格拉斯哥昏迷评分和定性量表（0至3）对意识水平进行评估。治疗前平均血糖为33.2±23.3mg/dL，治疗后升至133.3±57.3mg/dL。意识定性水平从平均1.26±0.96提高到2.42±0.94，格拉斯哥昏迷评分从平均9.0±4.19提高到13.04±3.68。在意识水平标准均有反应的患者中，平均反应时间为8.8分钟（82%，50例中的41例）。用于低血糖治疗的胰高血糖素使98%（50例中的49例）患者血糖升高，4%（50例中的2例）患者出现唯一副作用头痛（P<0.0001）。
胰高血糖素在院前环境中治疗低血糖安全有效。
