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非酮症性糖尿病高渗昏迷(NHDC)是由于血浆高渗状态引起的糖尿病急性并发症,昏迷与酮症无直接关系。1973年以来国内已有报道,由于对本病认识不足,易误诊漏诊。其病死率达50～69.5%。本文就我院1978～1986年收治的6例结合文献讨论。临床资料诊断标准:根据1984年NHDC的诊断治疗参考方案中3项主要指标:(1)血糖>600mg/dl;(2)有效渗透压>320mOsm/L;(3)尿糖强阳性,尿酮体阴性或弱阳性(中华医学杂志1984;64:179)。一般资料:男女各3例,年龄41～71(平均58.5)岁。5例无糖尿病史及“三多”症状史。主要诱因:感染(肺、泌尿系)5例;脑梗塞1例。
Non-ketotic hyperosmolar coma (NHDC) is an acute complication of diabetes due to hyperosmolarity in the plasma and is not directly related to ketosis. Since 1973, it has been reported in our country that due to lack of understanding of this disease, it is easy to misdiagnosis. The fatality rate of 50 to 69.5%. This article on our hospital from 1978 to 1986 admitted 6 cases with the literature discussion. Clinical data diagnostic criteria: According to the 1984 NHDC diagnostic treatment of reference three major indicators of the program: (1) blood glucose> 600mg / dl; (2) effective osmolality> 320mOsm / L; (3) strong positive urine glucose, urine ketone body negative Or weakly positive (Chinese Medical Journal 1984; 64: 179). General information: 3 males and 3 females, aged 41-71 (mean 58.5) years. 5 cases without diabetes history and “more than three” history of symptoms. The main incentive: infection (lung, urinary tract) in 5 cases; 1 case of cerebral infarction.