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高渗高血糖状态诱导的高黏滞血症作为多发性栓塞性中风的催化剂。

Hyperosmolar Hyperglycemic State-Induced Hyperviscosity as a Catalyst for Multiple Embolic Strokes.

作者信息

Escaño Lorena, Desai Prarthana

机构信息

Internal Medicine, Danbury Hospital, Danbury, USA.

出版信息

Cureus. 2024 Jun 27;16(6):e63331. doi: 10.7759/cureus.63331. eCollection 2024 Jun.

DOI:10.7759/cureus.63331
PMID:38947137
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11214331/
Abstract

Hyperosmolar hyperglycemic state (HHS) is the most serious emergency in patients with uncontrolled diabetes mellitus. It has been associated with a prothrombotic state that increases the risk for ischemia in affected patients. Despite the literature on the risk of ischemic stroke in patients with chronic hyperglycemia being vast, there is not enough documentation on the risk of developing a stroke during a hyperglycemic crisis. We present a rare case of an 86-year-old male who was admitted with HHS whose hospital course was further complicated by multiple embolic strokes. Prompt recognition of cerebral infarction when it intertwines with HHS remains a challenging task. This case emphasizes the value of clinical vigilance in patients with this hyperglycemic crisis. Further research is needed to better understand what this prothrombotic state truly entails in these patients.

摘要

高渗高血糖状态（HHS）是糖尿病控制不佳患者最严重的急症。它与血栓前状态有关，会增加受影响患者发生缺血的风险。尽管关于慢性高血糖患者缺血性卒中风险的文献众多，但关于高血糖危象期间发生卒中风险的记录并不充分。我们报告一例罕见病例，一名86岁男性因HHS入院，其住院过程因多发性栓塞性卒中而进一步复杂化。当脑梗死与HHS交织时，及时识别仍然是一项具有挑战性的任务。该病例强调了对这种高血糖危象患者进行临床监测的重要性。需要进一步研究以更好地了解这种血栓前状态在这些患者中的确切情况。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e97f/11214331/a94e245e9913/cureus-0016-00000063331-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e97f/11214331/a7c4a083931f/cureus-0016-00000063331-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e97f/11214331/0906034362b0/cureus-0016-00000063331-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e97f/11214331/9b2c58b6856a/cureus-0016-00000063331-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e97f/11214331/a94e245e9913/cureus-0016-00000063331-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e97f/11214331/a7c4a083931f/cureus-0016-00000063331-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e97f/11214331/0906034362b0/cureus-0016-00000063331-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e97f/11214331/9b2c58b6856a/cureus-0016-00000063331-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e97f/11214331/a94e245e9913/cureus-0016-00000063331-i04.jpg

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本文引用的文献

1
Hyperosmolar hyperglycaemic state as a stroke cause or stroke mimic: an illustrative case and review of literature.高渗性高血糖状态作为脑卒中的病因或脑卒中样发作：一个说明性病例及文献复习。
Clin Med (Lond). 2022 Jan;22(1):83-86. doi: 10.7861/clinmed.2021-0734.
2
Triple emergencies: Hyperosmolar hyperglycemic state, venous thromboembolism, and huge free-floating right heart thrombus successfully managed with anticoagulation.三重急症：高渗高血糖状态、静脉血栓栓塞症以及巨大游离右心血栓，经抗凝治疗成功处理。
Clin Case Rep. 2021 Dec 26;9(12):e04710. doi: 10.1002/ccr3.4710. eCollection 2021 Dec.
3
Increased risk of ischemic stroke after hyperosmolar hyperglycemic state: a population-based follow-up study.
高渗高血糖状态后缺血性中风风险增加：一项基于人群的随访研究。
PLoS One. 2014 Apr 8;9(4):e94155. doi: 10.1371/journal.pone.0094155. eCollection 2014.