抗外源性胰岛素抗体致顽固性低血糖临床分析  

Design and application effect of nursing record of critically ill patients with nosocomial transshipment

作　　者：李振洲[1] 黄佳佳[1] 刘燕[1] 张昕[1] 张耀芬[1] 

机构地区：[1]中国人民武装警察部队总医院干部病房三科,北京100039

出　　处：《中国急救复苏与灾害医学杂志》2015年第2期140-142,共3页China Journal of Emergency Resuscitation and Disaster Medicine

摘　　要：目的：探讨外源性胰岛素诱发自身抗体致顽固性低血糖的发病机制，为本病的诊断和治疗提供依据。方法回顾1例反复顽固性低血糖发作患者的临床诊治经过，并结合文献报告，分析抗外源性胰岛素抗体诱发低血糖的临床表现、实验室检查、治疗及预后。结果患者胰岛素释放实验表现为胰岛素水平异常升高，且与C肽的升高不同步。抗胰岛素抗体测定阳性。未发现胰岛细胞瘤及其他导致自身免疫性低血糖的病因。泼尼松片10 mg口服，每日3次，1周后低血糖未再发作。结论抗外源性胰岛素抗体可诱发低血糖，糖耐量实验和胰岛素抗体检测在本病的诊断中具有重要作用，糖皮质激素疗效良好。Objective To study the pathological mechanism of anti-exogenous insulin antibody induced refractory hypoglycemia, and provide the basis for diagnosis and treatment to the disease. Methods A case of recurrent hypoglycemia was retrospectively analyzed from its diagnosis and treatment combined with relevant literatures, analysis of clinical manifestations, laboratory examination, treatment and prognosis. Results The studied patient with hypoglycemia performed hyperinsulinemia which was unmatched with an increased C peptide. The test of anti-insulin antibody reflected positive. Insulinoma and other causes of autoimmune hypoglycemia were excluded. Hypoglycemia was not found to recur after orally taking prednisone 10mg three times a day for a period of one week. Conclusion Anti-exogenous insulin antibody is considered being effective in inducing hypoglycemia. Glucose tolerance test and insulin antibody detection plays an important role in diagnosing the disease.

关 键 词：低血糖 胰岛素 抗胰岛素抗体 

分 类 号：R589.1[医药卫生—内分泌]