High-risk factors for disorders of consciousness of hypoglycemia

Dongmei LIU; Yan ZHANG; Huabin HU; Pu HUANG; Jun YAN; Zhonghua YU; Wuquan DENG; Zhi'an HU; Zhongxiang YAO; Debin LU

doi:10.16016/j.1000-5404.202102144

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High-risk factors for disorders of consciousness of hypoglycemia

更新时间：2026-01-09

- High-risk factors for disorders of consciousness of hypoglycemia
- Journal of Third Military Medical University Vol. 43, Issue 17, Pages: 1679-1683(2021)
- 作者机构：
- 作者简介：
- 基金信息：
  
  the Fund for Creative Research Groups of National Natural Science Foundation of China(31921003)
- DOI：10.16016/j.1000-5404.202102144
  CLC：
- Received：25 February 2021，
  
  Published：15 September 2021
- 稿件说明：
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Dongmei LIU, Yan ZHANG, Huabin HU, et al. High-risk factors for disorders of consciousness of hypoglycemia[J]. Journal of Third Military Medical University, 2021, 43(17): 1679-1683.
DOI：

Dongmei LIU, Yan ZHANG, Huabin HU, et al. High-risk factors for disorders of consciousness of hypoglycemia[J]. Journal of Third Military Medical University, 2021, 43(17): 1679-1683. DOI： 10.16016/j.1000-5404.202102144.

摘要

目的

探讨低血糖患者出现意识障碍的高危因素及诱因。

方法

选择2010－2020年在中国科学院大学重庆仁济医院和重庆市急救医疗中心接受低血糖治疗住院患者108例为研究对象，分析患者性别、年龄、注射胰岛素或服用磺脲类药物、饮酒等高危因素与低血糖之间的关系；并按照患者入院时有无意识障碍分为意识障碍组(

=72)与无意识障碍组（

=36），比较两组间的糖尿病占比、血糖水平、低血糖持续时间、合并症（糖尿病、高血压、慢性阻塞性肺病、冠心病、肾病、脑卒中后遗症、肿瘤）等差异，结合CT和脑电图分析低血糖所致意识障碍的发病诱因及升糖治疗后的转归。

结果

108例低血糖患者以老年人为主（＞60岁者占89.80%），糖尿病患者多（70.40%）。72例（66.70%）合并意识障碍，其中54.17%有口服磺脲类降糖药物，为意识障碍主要诱因。与无意识障碍组比较，意识障碍组血糖水平明显降低(

0.001)，低血糖持续时间明显较长(

=0.047)，但糖尿病仅合并高血压患者明显较少(

=0.006)，而糖尿病合并高血压再合并1种以上其他合并症（慢性阻塞性肺炎、冠心病、肾病、脑卒中后遗症、肿瘤等）的占比明显较多(

=0.034)；两组间年龄、性别、血肌酐水平差异无统计学意义。另外，两组患者CT图像及意识恢复后脑电图并未见特异性改变和明显差异，经升糖治疗后均无明显后遗症，好转率高。

结论

低血糖意识障碍的主要诱因是口服磺脲类药物，而主要高危因素包括低血糖严重程度、低血糖持续时间及具有多种合并症，但糖尿病仅合并高血压患者在发生低血糖时相对不易出现意识障碍。

Abstract

Objective

To explore the high risk factors and causes of disorders of consciousness (DOC) in hypoglycemia patients.

Methods

A total of 108 patients receiving hypoglycemia treatment in Chongqing Renji Hospital and Chongqing Emergency Medical Center from January 2010 to December 2020 were enrolled in this study. The relationships of sex

age

insulin injection or administration of sulfonylurea drugs and alcohol consumption with hypoglycemia were analyzed. According to being conscious or not

the patients were divided into DOC group (

=72) and non-DOC group (

=36). The differences of being diabetes mellitus or not

blood glucose level

hypoglycemia duration

and complications (diabetes

hypertension

chronic obstructive pulmonary disease

coronary heart diseases

nephropathy

sequelae of stroke and tumors) were compared between the 2 groups. The causes of DOC by hypoglycemia and outcome after glucose raising treatment were analyzed in combination with CT i

mages and results of electroencephalography (EEG).

Results

The 108 hypoglycemia patients were majorly old aged (89.8%

over 60 years old) and had diabetes mellitus (70.4%). Seventy-two of them (66.7%) were complicated with DOC

and about 54.17% of them took sulfonylurea hypoglycemic drugs

which was the main inducement of hypoglycemic DOC. Compared with the non-DOC group

the blood glucose level was obviously reduced and the duration of hypoglycemia was notably longer in the DOC group

but the ratio of patients with diabetes mellitus combined with hypertension were significantly less

while the ratio of patients with the 2 above diseases with hypertension and another one or more complications simultaneously (such as chronic obstructive pulmonary inflammation

coronary heart diseases

kidney disease

stroke sequelae

and tumor

etc

.) were significantly larger. There were no significant differences in age

sex and serum creatinine between the 2 groups. In addition

no statistical differences were seen in CT images and EEGs after recovery from DOC. After the treatment of glucose

no obvious sequelaes occurred and the improvement rate was quite high.

Conclusion

The main inducement of hypoglycemic DOC is oral administration of sulfonylurea

and the main high-risk factors are the severity of hypoglycemia

duration of hypoglycemia and having 3 or more complications. The patients with both diabetes mellitus and hypertension are relatively not so easy to develop hypoglycemic DOC.

关键词

Keywords

references

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