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糖尿病并发昏迷的鉴别

来源:华人健康网 | 发布时间:2010-12-22 16:20:25 | www.chinesejk.com

酮症酸中毒低血糖昏迷高渗性昏迷乳酸性酸中毒
病史青少年多,常有感染及胰岛素治疗中断史有注射胰岛素、口服降糖药进食少等病史老年多,可无糖尿病史,有感染呕吐腹泻史常有肝肾功能不全,休克心衰饮酒服DBI史
起病症状慢(2-4天)厌食恶心呕吐烦渴多尿急(以小时计)饥饿多汗心慌手抖等慢(数日)嗜睡幻觉震颤抽搐较急有厌食恶心昏睡等
体征皮肤失水明显潮湿多汗失水明显失水
呼吸深大正常快或正常或不规则深
血压下降正常或稍高下降下降
化验尿糖 - ~ -~
尿酮 --~ -~±
血糖↑↑↑↓↓↓(16.7~33.3mmol/L)↑↑↑(<2.8mmol/L)正常或↑(多>33.3mmol/L)
血钠↓或正常正常↑↑~↑↑↑↓或正常
PH↓正常正常或↓↓~↓↓
HCO3-↓正常正常或↓↓~↓↓
乳酸稍↑正常正常↑↑
血浆渗透压正常或↑正常↑↑↑常>350mOs/L正常


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