动态血糖监测系统探讨胰岛素瘤患者日间与夜间的血糖波动  

Application of continuous glucose monitoring system to explore the blood glucose fluctuation model of insulinoma

作　　者：丁波[1] 孙睿[1] 沈赟[1] 罗勇[1] 马建华[1] 

机构地区：[1]南京医科大学附属南京第一医院内分泌科,江苏南京210012

出　　处：《中国医药导报》2013年第29期57-58,61,共3页China Medical Herald

摘　　要：目的通过动态血糖监测系统（CGMS）分析胰岛素瘤患者日间与夜间血糖谱特点，探讨CGMS在胰岛素瘤诊断中的价值。方法选择2006年3月-2012年6月在南京医科大学附属南京第一医院住院胰岛素瘤患者12例，均进行连续3d的动态血糖监测，比较日间与夜间平均血糖水平、最高血糖、最低血糖、平均血糖波动幅度（MAGE）、最大血糖波动幅度（LAGE）及低血糖发生率，并分析CGMS监测结果与胰岛素释放指数（IRI／G）的相关性。结果胰岛素瘤患者日间平均血糖水平[（5．23±1．33）mmol／L]、日间血糖最高值[（9．83±2．36）mmol／L]、日间MAGE[（6．27±1．37）mmol／L]及LAGE[（8．25±2．24）mmol／L]均高于夜间[（4．18±1．19）、（7．34±1．97）、（4．38±1．22）、（6．37±2．11）mmol／L]，差异均有统计学意义（P〈0．05）；夜间低血糖发生率（63．4％）高于日间（36．6％），差异有统计学意义（P〈0．05）。相关分析显示全天平均血糖波动幅度与胰岛素释放指数呈正相关（r=0．624，P=0．008）。结论胰岛素瘤患者日间血糖波动较大，夜间低血糖风险大，CGMS在胰岛素瘤临床诊治中具有重要价值。Objective To evaluate the value of continuous glucose monitoring system （CGMS） in the diagnosis of insulinoma by analyse the characterisitics of blood glucose profiles of insulinoma using CGMS. Methods A total of 12 insulinoma patients hospitalized in Nanjing First Hospital Affiliated to Nanjing Medical University from March 2006 to June 2012 were observed by CGMS for 3 days. The mean blood glucose, highest and lowest blood glucose, mean amplitude of glycemic excursions （MAGE）, largest amplitude of glycemic excursions （LAGE） and the incidence of hypoglycemia in daytime were compared with those of nighttime. Results The mean blood glucose [（5.23±1.33） mmol/L], highest blood glucose [（9.83±2.36） mmol/L], MAGE [（6.27±1.37） mmol/L] and LAGE [（8.25±2.24） mmol/L] of daytime were higher than those of nighttime [（4.18±1.19）, （7.34± 1.97）, （4.38±1.22）, （6.37±2.11） mmol/L], the differences were statistically significant （P 〈 0.05）.The incidence of hypoglycemia in night （63.4%） was higher than that of daytime （36.6%）. The correlation analysis showed that all day MAGE was positively correlated with IRI/G （r = 0.624, P = 0.008）. Conclusion There is a obvious fluctuation of daytime blood glucose and a higher risk of hypoglycemia in night of insulinoma patients, CGMS has important value in the diagnosis of insulinoma.

关 键 词：胰岛素瘤 动态血糖监测系统 血糖波动 

分 类 号：R587.1[医药卫生—内分泌]