Rolfe M, Ephraim G G, Lincoln D C, Huddle K R
Department of Medicine, Baragwanath Hospital, Johannesburg.
S Afr Med J. 1995 Mar;85(3):173-6.
There were 136 emergency hyperglycaemic admissions to Baragwanath Hospital over a 6-month period during 1992-1993, representing 1.2% of the total number of medical admissions; 24 (18%) patients died. Diabetic keto-acidosis (DKA) accounted for 88 (65%) admissions (mortality rate 9%) while 16 admissions (12%) were as a result of hyperosmolar non-ketotic coma (HNKC), defined as hyperglycaemia, dehydration and an altered level of consciousness with a plasma osmolality > or = 330 and an arterial pH > or = 7.30, with absent or minimal ketonuria. Of these 16 patients, 9 (56%) were known to have diabetes mellitus. Patients with HNKC were significantly older than those with DKA (P < 0.001) and other patients with nonketotic hyperglycaemia (P < 0.05). The overall mortality rate was 44%; prophylactic low-molecular-weight heparin appeared of benefit (P < 0.05).
在1992年至1993年的6个月期间，有136例高血糖急症患者入住巴拉格瓦纳特医院，占内科住院患者总数的1.2%；24例（18%）患者死亡。糖尿病酮症酸中毒（DKA）占88例（65%）住院病例（死亡率9%），而16例（12%）因高渗非酮症昏迷（HNKC）入院，其定义为高血糖、脱水以及意识水平改变，血浆渗透压≥330且动脉pH值≥7.30，尿酮体缺失或极少。在这16例患者中，9例（56%）已知患有糖尿病。HNKC患者比DKA患者明显年长（P<0.001），也比其他非酮症高血糖患者年长（P<0.05）。总体死亡率为44%；预防性使用低分子量肝素似乎有益（P<0.05）。
