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糖尿病酮症酸中毒患者出现意识障碍的原因,曾被认为是由于失水、低血压、酸血症,酮血症及大脑葡萄糖代谢障碍等,但均有争论。本文报告了42例70次糖尿病酮症酸中毒的观察研究。42例均患未控制的糖尿病,血清酮体试验阳性,血pH值低于7.37,非酮症高血糖昏迷患者除外。按意识障碍的程度将患者分为五组:第一组意识清醒或轻度嗜睡(26次发作);第二组中度嗜睡(24次发作);第三组重度嗜睡(14次发作);第四组接近昏迷(3次发作);第五组昏迷(3次发作)。第一和第二组患者血pH平均值为7.13±0.02,第四和第五组的平均值为7.09±0.06,t值为0.619,P值>0.5。三例次昏迷患者仅1例有明显酸血症,pH值为6.87,另两例pH值为7.13及7.25。血pH值
The causes of disturbance of consciousness in patients with diabetic ketoacidosis have been thought to be due to dehydration, hypotension, acidosis, ketosis and brain glucose metabolism disorder, but are controversial. This article reports 42 cases of 70 cases of diabetic ketoacidosis observed. 42 patients had uncontrolled diabetes, serum ketone test was positive, blood pH was lower than 7.37, non-ketotic hyperglycemic coma in patients with exception. Patients were divided into five groups according to the degree of disturbance of consciousness: the first group was conscious or mild drowsiness (26 episodes); the second group was moderate drowsiness (24 episodes); the third group was severe drowsiness (14 episodes); The fourth group is close to coma (3 attacks); the fifth coma (3 attacks). In the first and second groups, the average blood pH was 7.13 ± 0.02, the average in the fourth and fifth groups was 7.09 ± 0.06, the t value was 0.619 and the P value was> 0.5. Only one patient in three cohorts had a clear acidosis with a pH of 6.87 and the other two had a pH of 7.13 and 7.25. Blood pH