Shakir K M, Amin R M
Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland.
Crit Care Clin. 1991 Jan;7(1):75-87.
Hypoglycemia is defined as the occurrence of a wide variety of symptoms in association with a plasma glucose level of 40 mg/dL or less. The conditions associated with hypoglycemia in hospitalized patients include exogenous insulin administration, ethanol, drugs (especially chlorpropamide), renal insufficiency, liver disease, infections, total parenteral nutrition, treatment of hyperkalemia with insulin, extensive burns, neoplasia, pregnancy, and a wide variety of less common causes. Although clinical features are helpful in making a diagnosis, a significant proportion of the patients are either asymptomatic or present with symptoms of altered mental status. The diagnosis of hypoglycemia should be considered in all hospitalized patients presenting with adrenergic or neuroglycopenic symptoms and signs suggestive of hypoglycemia. A detailed history along with a physical examination and appropriate laboratory investigations usually identify the specific cause of the hypoglycemia. An episode of hypoglycemia, especially if severe, should be treated with prolonged intravenous infusion of glucose. Prompt recognition and management of hypoglycemia are necessary to prevent significant morbidity and mortality.
低血糖症的定义为出现与血浆葡萄糖水平40mg/dL或更低相关的多种症状。住院患者中与低血糖症相关的情况包括外源性胰岛素给药、乙醇、药物（尤其是氯磺丙脲）、肾功能不全、肝脏疾病、感染、全胃肠外营养、用胰岛素治疗高钾血症、大面积烧伤、肿瘤、妊娠以及各种不太常见的病因。尽管临床特征有助于做出诊断，但相当一部分患者要么无症状，要么表现为精神状态改变的症状。对于所有出现提示低血糖症的肾上腺素能或神经低血糖症状和体征的住院患者，均应考虑低血糖症的诊断。详细的病史、体格检查以及适当的实验室检查通常可确定低血糖症的具体病因。低血糖发作，尤其是严重发作时，应通过长时间静脉输注葡萄糖进行治疗。迅速识别和处理低血糖症对于预防严重的发病率和死亡率至关重要。
