Saikawa Rika, Yamada Hodaka, Suzuki Daisuke, Amamoto Misato, Matsumoto Yuko, Funazaki Shunsuke, Yoshida Masashi, Toyoshima Hideo, Hara Kazuo
Department of Medicine, Division of Endocrinology and Metabolism, Jichi Medical University, Saitama Medical Center, 1-847 Amanuma-cho, Omiya-ku, Saitama, Japan.
J Clin Med Res. 2019 Mar;11(3):213-218. doi: 10.14740/jocmr3728. Epub 2019 Feb 13.
The aim of the study was to investigate risk factors of hypoglycemic encephalopathy (HE) in patients with severe hypoglycemia.
We retrospectively enrolled patients with severe hypoglycemia who were transported to the emergency department in an ambulance. We defined severe hypoglycemia as plasma glucose level < 60 mg/dL (or capillary levels < 50 mg/dL). HE was defined as severe hypoglycemia with altered level of consciousness (Glasgow coma scale < 12) and prolonged HE as coma or stupor lasting > 24 h after glucose administration. We compared several parameters between patients with and without HE and between prolonged and recovered patients.
Included were 173 patients with severe hypoglycemia; of them, 94 were diagnosed with HE, with 12 of them prolonged HE. Glucose level in HE patients was lower than that in those without HE (P < 0.001). Moreover, we noted a significant difference in glucose levels between the prolonged and recovered groups. Furthermore, body temperature was higher in prolonged versus recovered patients (P = 0.0017).
Blood glucose level may be correlated with severity of altered level of consciousness. In addition, body temperature may be related to coma or prolonged stupor.
本研究旨在调查严重低血糖患者发生低血糖性脑病（HE）的危险因素。
我们回顾性纳入了通过救护车转运至急诊科的严重低血糖患者。我们将严重低血糖定义为血浆葡萄糖水平<60mg/dL（或毛细血管血糖水平<50mg/dL）。HE被定义为伴有意识水平改变（格拉斯哥昏迷量表<12）的严重低血糖，而延长的HE是指在给予葡萄糖后昏迷或昏睡持续>24小时。我们比较了有和没有HE的患者之间以及延长和恢复的患者之间的几个参数。
纳入了173例严重低血糖患者；其中，94例被诊断为HE，其中12例为延长的HE。HE患者的血糖水平低于无HE患者（P<0.001）。此外，我们注意到延长组和恢复组之间的血糖水平存在显著差异。此外，延长组患者的体温高于恢复组患者（P = 0.0017）。
血糖水平可能与意识水平改变的严重程度相关。此外，体温可能与昏迷或延长的昏睡有关。
