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低血糖已经很少地被认为是严重细菌性脓毒的临床征象.我们最近碰到9例危重的脓毒症病人合并有低血糖(平均血糖浓度为22mg/dl).这些病人的临床疾病包括肺炎和蜂窝织炎,三个病人没有明显的感染病灶.这些病例的共同表现是精神状态的改变,代谢性酸中毒,白细胞减少,血凝异常和菌血症.四例除脓毒病外没有其他低血糖的原因.五例有低血糖的另外可能的代谢性原因(四例酒精中毒和一例慢性肾功能不全),但是在以往的住院期间没有一例发现过低血糖.最常见的病原是肺炎双球菌(三例)和B型流感嗜血杆菌(两例),总的死亡率是67%.
Hypoglycaemia has rarely been considered a clinical sign of severe bacterial sepsis and we recently encountered 9 critically ill sepsis patients with hypoglycaemia (mean blood glucose concentration 22 mg / dl) .The clinical conditions in these patients included Pneumonia and cellulitis, three patients had no significant infectious lesions.The common manifestations of these cases were changes in mental status, metabolic acidosis, leucopenia, hemagglutination and bacteremia, except for four cases of sepsis Other causes of hypoglycemia Five patients had other possible metabolic causes of hypoglycemia (four with alcoholism and one with chronic renal insufficiency), but none of the previous hospitalizations found hypoglycemia.The most common cause was pneumonia Diphtheria (three cases) and Haemophilus influenzae type B (two cases), the overall mortality rate was 67%.