Ekpebegh C, Longo-Mbenza B
Department of Internal Medicine, Faculty of Health Sciences, Walter Sisulu University, Mthatha, Eastern Cape Province, South Africa.
Minerva Endocrinol. 2011 Dec;36(4):267-72.
The aim of this paper was to determine the prevalence of altered sensorium and their determinants in diabetic ketoacidosis (DKA).
Retrospective review of medical records for diabetic ketoacidosis admissions over a two year period.
A total of 94 admissions for DKA in 89 patients were reviewed. Majority of admissions were female related. The mean age of the subjects was 39.1±18.5 years. The prevalence of altered sensorium defined as Glasgow coma scale (GCS) below 15 was 47.9%. In Model 1, systolic blood pressure (SBP) <90 mmHg (odds ratio [OR] 17.5 95% Confidence Interval (CI) 2.1-142.9; P=0.008 and calculated effective serum osmolality >320 mosmol/Kg (OR 3.6 95% CI 1.4-12.2; P=0.043 were independently associated with altered sensorium. In Model 2 where serum osmolality was substituted with uncorrected serum sodium, SBP <90 mmHg OR 19.6 95% CI 2.2-100; P=0.007, uncorrected serum sodium >150 mmol/L OR 18.5 95% CI 2.1-100; P=0.0009 and white cell count >25 x 106/L OR 3.6 95% CI 1.03-13.5; P=0.05 were independently associated with altered sensorium.
Systolic blood pressure <90 mmHg, calculated effective serum osmolality >320 mosmol/Kg, uncorrected serum sodium >150 mmol/L and white bood count >25 x 106/L were independently associated with altered sensorium.
本文旨在确定糖尿病酮症酸中毒（DKA）患者意识改变的发生率及其决定因素。
回顾性分析两年期间糖尿病酮症酸中毒住院患者的病历。
共回顾了89例患者的94次DKA住院病例。大多数住院患者为女性。受试者的平均年龄为39.1±18.5岁。意识改变定义为格拉斯哥昏迷量表（GCS）低于15分，其发生率为47.9%。在模型1中，收缩压（SBP）<90 mmHg（比值比[OR]17.5，95%置信区间[CI]2.1 - 142.9；P = 0.008）以及计算得出的有效血清渗透压>320 mosmol/Kg（OR 3.6，95% CI 1.4 - 12.2；P = 0.043）与意识改变独立相关。在模型2中，用未校正血清钠替代血清渗透压后，SBP <90 mmHg（OR 19.6，95% CI 2.2 - 100；P = 0.007）、未校正血清钠>150 mmol/L（OR 18.5，95% CI 2.1 - 100；P = 0.0009）以及白细胞计数>25×10⁶/L（OR 3.6，95% CI 1.03 - 13.5；P = 0.05）与意识改变独立相关。
收缩压<90 mmHg、计算得出的有效血清渗透压>320 mosmol/Kg、未校正血清钠>150 mmol/L以及白细胞计数>25×10⁶/L与意识改变独立相关。
