胰岛β细胞瘤12例临床分析  

Clinical Analysis of Twelve Cases of Insulinoma

作　　者：刘成[1,2] 刘兴贵[3] 徐淑静[2] 

机构地区：[1]贵阳医学院 [2]贵阳医学院附院内分泌科,贵州贵阳550004 [3]贵阳医学院附院肝胆外科,贵州贵阳550004

出　　处：《贵阳医学院学报》2015年第5期504-506,510,共4页Journal of Guiyang Medical College

摘　　要：目的：探讨胰岛β细胞瘤的临床特点,避免误诊误治。方法：外科手术治疗并经病理确诊的12例胰岛β细胞瘤患者,分析其影像学检查资料、空腹血糖、胰岛素、C肽水平、胰岛素/血糖比值及治疗结果。结果：病理确诊为单发肿瘤11例,多发1例;术前B超检查10例,阳性4例（40%）,CT检查10例,阳性9例（90%）,核磁共振成像（MRI）检查4例,阳性3例（75%）;所有患者空腹血糖范围为0.25～2.90 mmol/L,12例均〈3.0 mmol/L;胰岛素水平为4.63～82.09 m IU/L,12例〉3.0 m IU/L;C肽0.26～1 100.71 pmol/L,〉200 pmol/L者4例;低血糖发作时胰岛素释放指数〉0.4者7例（58%）,5例胰岛素释放指数小于0.4,占总例数的42%;本组患者均为良性肿瘤,手术后均治愈。结论：当患者反复出现低血糖反应或不明原因神经精神症状时,应监测血糖,及时发现低血糖症并追究低血糖发生的原因,避免漏诊及误诊胰岛素β细胞瘤。Objective： To explore the clinical signs and features of insulinoma in order to avoid misdiagnosis and therapeutic error. Methods： Twelve patients with insulinoma confirmed by means of surgical resection and pathology were enrolled in this study. The clinical data such as fasting blood-glucose,plasma insulin level,c-peptide level,insulin-glucose ratio and imaging examination and therapeutic outcome were analyzed. Results： Eleven cases of single tumor and 1 case of multiple tumors were diagnosed by pathology. Before surgery 10 cases were examined with type-B ultrasonic check,the positive rate being 40%; 10 cases were examined with CT,the positive rate being 90%; four cases were examined with MRI,the positive rate being 75%. All patients＇ fasting blood-glucose ranged from0. 25 to 2. 90 mmol / L,all the cases were below 3. 0 mmol / L. All patients＇ plasma insulin levels ranged from 4. 63 to 82. 09 m IU / L,of which 12 patients＇ plasma insulin levels were〉 3. 0 m IU / L. 12 patients＇ c-peptide level ranged from 0. 26 to 1 100. 71 pmol / L,of which 4 patients＇ c-peptide level was〉 200 pmol / L. When hypoglycemia occurred,there were 7 cases whose insulin release index was 〈0. 4（ 58 %） and 5 cases whose 0. 4（ 42 %）. All the above cases were benign tumors and cured by means of surgery. Conclusion： When the clinical manifestations of hypoglycemia occur repeatedly or there are unexplained symptoms of neuro-psychiatric disorders,plasma glucose should be monitored so that hypoglycemia can be discovered in time and avoid missed diagnosis and misdiagnosis of insulinoma.

关 键 词：胰岛Β细胞瘤 血糖 胰岛素 C肽 

分 类 号：R735.9[医药卫生—肿瘤]