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非糖尿病男性在中度胰岛素诱导低血糖后神经生理功能、表现及主观症状的恢复情况

Restitution of neurophysiological functions, performance, and subjective symptoms after moderate insulin-induced hypoglycaemia in non-diabetic men.

作者信息

Lindgren M, Eckert B, Stenberg G, Agardh C D

机构信息

Department of Clinical Neurophysiology, Lund University, Sweden.

出版信息

Diabet Med. 1996 Mar;13(3):218-25. doi: 10.1002/(SICI)1096-9136(199603)13:3<218::AID-DIA25>3.0.CO;2-D.

Abstract

The restoration of cognitive function was studied in 10 healthy men aged 26 years (25.5 +/- 1.2 years; mean +/- SD) after insulin-induced hypoglycaemia (arterialized blood glucose 2.5 +/- 0.4 mmol l-1) for 62 +/- 8 min. Another group of six men participated in a single blind sham study for comparison. The hypoglycaemic event caused a significant increase (p = 0.006) in serum adrenaline levels. Ratings of adrenergically mediated symptoms increased during hypoglycaemia (p = 0.006), as did neuroglycopenic symptoms (p = 0.002), although neuroglycopenia ratings increased in both studies. During hypoglycaemia, P300 amplitudes in a relatively demanding visual search task decreased (p = 0.02), whereas easier tasks were unaffected. The amplitudes were restored after 40 min of normoglycaemia. Reaction time deteriorated after restoration of normoglycaemia, suggesting an effect of hypoglycaemia on learning. Thus, hypoglycaemia at a blood glucose level that is common among patients treated with insulin causes clear cognitive dysfunction, although restoration of the cognitive dysfunction to normal was fast.

摘要

对10名26岁(25.5±1.2岁;均值±标准差)的健康男性在胰岛素诱导低血糖(动脉化血糖2.5±0.4 mmol l-1)62±8分钟后认知功能的恢复情况进行了研究。另一组6名男性参与了一项单盲假手术研究作为对照。低血糖事件导致血清肾上腺素水平显著升高(p = 0.006)。低血糖期间,肾上腺素介导症状的评分增加(p = 0.006),神经低血糖症状评分也增加(p = 0.002),尽管两项研究中神经低血糖评分均增加。在低血糖期间,一项要求相对较高的视觉搜索任务中的P300波幅降低(p = 0.02),而较简单的任务则未受影响。血糖正常40分钟后波幅恢复。血糖恢复正常后反应时间变差,提示低血糖对学习有影响。因此,胰岛素治疗患者中常见血糖水平的低血糖会导致明显的认知功能障碍,尽管认知功能障碍恢复正常很快。

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