一般并不认为低血糖症是恶性疟疾的重要并发症,作者报告了泰国东部恶性疟疾并发低血糖症的发生情况、临床表现和发病机制。17例恶性疟疾中轻症3例;重症14例。其中呈脑型疟疾表现者12例;并发肾功能衰竭者4例。作者观察到恶性疟疾患者并发低血糖症是一种常见和严重的临床问题,低血糖的程度常常是严重而且容易反复发作。17例恶性疟疾患者共有30次低血糖症发作,发作时均伴血浆胰岛素和C多肽浓度的升高,且患者血浆乳酸和丙氨酸浓度亦显著升高。重症患者常有高疟原虫血症、肾脏受累和高病死率,本组14例重症患者中8例死亡,病死率为57％,其中5例死于乳酸中毒,血浆乳酸浓度的升高与高疟原虫血症密切相关。 17例恶性疟疾患者中16例接受奎宁治疗,作者观察到于低血糖症发作时血浆奎宁浓度和胰岛素浓度显 Hypoglycemia is not generally considered an important complication of malignant malaria and the authors report the incidence, clinical presentation and pathogenesis of severe malaria complicated with hypoglycemia in eastern Thailand. 17 cases of mild malaria in 3 cases; severe in 14 cases. Including cerebral malaria performance in 12 cases; complicated by renal failure in 4 cases. The authors observed that concurrent hypoglycemia in patients with falciparum malaria is a common and serious clinical problem, and the degree of hypoglycaemia is often severe and prone to recurrent episodes. A total of 17 patients with malignant malaria had 30 episodes of hypoglycemia, with both elevated plasma insulin and C-peptide levels at onset and a significant increase in plasma lactate and alanine concentrations. Serious Plasmodium falciparum, renal involvement and high mortality in critically ill patients, 8 of 14 critically ill patients died in this group, with a mortality rate of 57%, of which 5 died of lactic acidosis and elevated plasma lactate concentrations Plasmodium is closely related. Of the 17 patients with malignant malaria, 16 received quinine and the authors observed that plasma quinine and insulin concentrations were significantly higher in the episode of hypoglycemia