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本文报告3例脑血管病病人,由于甘露醇脱水治疗所引起高渗性非酮症性糖尿病昏迷。均无糖尿病病史。入院后经腰穿和脑CT确诊。静脉输入甘露醇期间,血糖升高达609～840mg%,尿糖(++),尿酮体(-)。最终均死亡。我们认为在颅内病变脱水治疗时,若有血糖上升或病人意识障碍并未因脱水而好转,且逐渐加重时,应警惕本病可能。本文还讨论了甘露醇诱发本病可能机理。
This article reports 3 patients with cerebrovascular disease, due to mannitol dehydration caused by hyperosmolar non-diabetic diabetic coma. No history of diabetes. After admission by lumbar puncture and brain CT confirmed. During intravenous mannitol, blood glucose up to 609 ~ 840mg%, urine sugar (++), urinary ketone body (-). Eventually died. We believe that in the treatment of intracranial lesions dehydration, if there is an increase in blood glucose or patient disturbance of consciousness did not improve due to dehydration, and gradually increased, should be wary of the disease may be. This article also discussed the possible mechanism of mannitol-induced disease.