因为缺乏基于人群的研究,且这类患者常有多种合并症,所以很难确定高血糖高渗性状态 (HHS) 的确切患病率和发病率。但是,在所有糖尿病相关的住院患者中,总患病率估计小于 1%。[9]Umpierrez GE, Kelly JP, Navarrete JE, et al. Hyperglycemic crises in urban Blacks. Arch Intern Med. 1997 Mar 24;157(6):669-75.http://www.ncbi.nlm.nih.gov/pubmed/9080921?tool=bestpractice.com[10]Kitabchi AE, Fisher JN, Murphy MB, et al. Diabetic ketoacidosis and the hyperglycemic hyperosmolar nonketotic state. In: Kahn CR, Weir GC, eds. Joslin's diabetes mellitus. 13th ed. Philadelphia, PA: Lea and Febiger; 1994:738-70. 据估算,HHS 的发病率为 17.5/100,000 患者年。[6]Lorber D. Nonketotic hypertonicity in diabetes mellitus. Med Clin North Am. 1995 Jan;79(1):39-52.http://www.ncbi.nlm.nih.gov/pubmed/7808094?tool=bestpractice.com
HHS 在老年人中最常见,以及美国的有糖尿病非裔美国人中也常见。[10]Kitabchi AE, Fisher JN, Murphy MB, et al. Diabetic ketoacidosis and the hyperglycemic hyperosmolar nonketotic state. In: Kahn CR, Weir GC, eds. Joslin's diabetes mellitus. 13th ed. Philadelphia, PA: Lea and Febiger; 1994:738-70. 据报告,HHS 患者的死亡率在 5% 到 20% 之间,比报告的糖尿病酮症酸中毒患者死亡率高 10 倍。[2]Kitabchi AE, Umpierrez GE, Miles JM, et al. Hyperglycemic crises in adult patients with diabetes. Diabetes Care. 2009 Jul;32(7):1335-43.http://care.diabetesjournals.org/content/32/7/1335.longhttp://www.ncbi.nlm.nih.gov/pubmed/19564476?tool=bestpractice.com[11]Fadini GP, de Kreutzenberg SV, Rigato M, et al. Characteristics and outcomes of the hyperglycemic hyperosmolar non-ketotic syndrome in a cohort of 51 consecutive cases at a single center. Diabetes Res Clin Pract. 2011 Nov;94(2):172-9.http://www.ncbi.nlm.nih.gov/pubmed/21752485?tool=bestpractice.com 如果患者年龄大于 70 岁,则死亡率显著增加。[12]Wachtel TJ, Silliman RA, Lamberton P. Prognostic factors in the diabetic hyperosmolar state. J Am Geriatr Soc. 1987 Aug;35(8):737-41.http://www.ncbi.nlm.nih.gov/pubmed/3611564?tool=bestpractice.com 在所有的高血糖突发事件中,大约 25% 的患者可见严重的高血糖、高渗压浓度和代谢性酸中毒的联合症状。[5]Wachtel TJ, Tetu-Mouradjian LM, Goldman DL, et al. Hyperosmolarity and acidosis in diabetes mellitus: a three-year experience in Rhode Island. J Gen Intern Med. 1991 Nov-Dec;6(6):495-502.http://www.ncbi.nlm.nih.gov/pubmed/1765864?tool=bestpractice.com[13]Chung ST, Perue GG, Johnson A, et al. Predictors of hyperglycaemic crises and their associated mortality in Jamaica. Diabetes Res Clin Pract. 2006 Aug;73(2):184-90.http://www.ncbi.nlm.nih.gov/pubmed/16458989?tool=bestpractice.com[14]Magee MF, Bhatt BA. Management of decompensated diabetes. Diabetic ketoacidosis and hyperglycemic hyperosmolar syndrome. Crit Care Clin. 2001 Jan;17(1):75-106.http://www.ncbi.nlm.nih.gov/pubmed/11219236?tool=bestpractice.com