以低血糖为首发症状的胰岛素瘤31例临床分析  

A clinical analysis on 31 cases of insulinoma with hypoglycemia as the first symptom

作　　者：王坤林[1] 周红文[1] 

机构地区：[1]南京医科大学第一附属医院内分泌病科,210029

出　　处：《江苏医药》2011年第24期2917-2919,共3页Jiangsu Medical Journal

基　　金：江苏省兴卫工程医学重点人才(RC2011177)

摘　　要：目的分析以低血糖为首发症状的胰岛素瘤的临床特征及诊断方法。方法从以低血糖症收治入院的91例病例中筛选出31例胰岛素瘤患者,对其相关临床资料进行回顾性分析。结果 31例胰岛素瘤患者中,21例空腹低血糖发作时胰岛素释放指数(IRI/G)>0.3。术前B超、CT以及MRI检查对胰岛素瘤的诊断阳性率分别为13.3%、57.7%和28.6%。15例进行手术治疗,14例发现肿瘤,且均为单发病灶,肿瘤位于胰头、尾部多于胰体部,肿瘤直径0.5～3cm。结论同步测定血清胰岛素原和β-羟丁酸的浓度有助于胰岛素、C肽等生化指标不典型的胰岛素瘤的定性诊断。48-h饥饿实验可取代72-h饥饿试验成为胰岛素瘤定性诊断的新标准。Objective To analyze the clinical features and diagnosis of insulinoma in 31 cases,in whom hypoglycemia was the first symptom.Methods Data of 31 patients with insulinoma were retrospectively analyzed.Results Of 31 patients,21 cases had an insulin release index（IRI/G） of greater than 0.3 during fasting hypoglycemia attack.The sensitivities of preoperative-B ultrasonography,CT and MRI were 13.3%,57.7% and 28.6%,respectively.Surgical management was performed in 15 cases,of whom 14 patients were found to have a single tumor.The majority of tumors were located in the head and tail of the pancreas with 0.5 to 3 cm in diameter.ConclusionCombined detection of serum proinsulin and β-hydroxybutyrate is beneficial to the diagnosis of insulinoma in which insulin and C-peptide has not fulfiled the diagnostic criteria.The 48-h fasting test should replace for the 72-h one as a new diagnostic standard.

关 键 词：胰岛素瘤 低血糖症 WHIPPLE三联征 

分 类 号：R587[医药卫生—内分泌]