Yao H, Sadoshima S, Nishimura Y, Fujii K, Oshima M, Ishitsuka T, Fujishima M
Second Department of Internal Medicine, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
J Neurol Neurosurg Psychiatry. 1989 Mar;52(3):372-5. doi: 10.1136/jnnp.52.3.372.
Cerebrospinal fluid (CSF) lactate and pyruvate concentrations were determined in 20 patients with diabetes mellitus but without disturbance of consciousness and five who recovered from hypoglycaemic coma. CSF lactate was slightly but significantly higher in diabetes mellitus (1.78, SEM 0.04 m mol/l) than that in 15 control subjects (1.40, SEM 0.05 m mol/l). In those who recovered from hypoglycaemic coma, CSF lactate was markedly elevated to 2.45-4.43 m mol/l. CSF glucose concentrations, however, were substantially the same between treated hypoglycaemic and diabetes mellitus groups. These findings indicate that CSF lactate levels increase with glycaemic levels in diabetes mellitus owing to enhanced glucose influx into glycolytic pathway of the brain, and also increases in treated hypoglycaemic coma probably due to mitochondrial dysfunction or damage.
测定了20例无意识障碍的糖尿病患者及5例从低血糖昏迷中恢复的患者的脑脊液（CSF）乳酸盐和丙酮酸盐浓度。糖尿病患者的脑脊液乳酸盐略高于但显著高于15名对照受试者（分别为1.78，标准误0.04 mmol/L和1.40，标准误0.05 mmol/L）。在从低血糖昏迷中恢复的患者中，脑脊液乳酸盐显著升高至2.45 - 4.43 mmol/L。然而，低血糖治疗组和糖尿病组的脑脊液葡萄糖浓度基本相同。这些发现表明，糖尿病患者脑脊液乳酸盐水平随血糖水平升高，这是由于大脑糖酵解途径中葡萄糖流入增加所致，而在低血糖昏迷治疗后其升高可能是由于线粒体功能障碍或损伤。
