临床病例讨论 第495例——青年女性-高雄激素血症-严重胰岛素抵抗  

The 495th case:young female-hyperandrogenemia-severe insulin resistance

作　　者：崔云英 贾觉睿智 陈美平 卢琳 于淼 王林杰 Yunying Cui;Ruizhi Jiajue;Meiping Chen;Lin Lu;Miao Yu;Linjie Wang(State Key Laboratory of Complex Severe and Rare Diseases,Key Laboratory of Endocrinology of National Health Commission,Department of Endocrinology,Peking Union Medical College Hospital,Peking Union Medical College,Chinese Academy of Medical Sciences,Beijing 100730,China)

机构地区：[1]中国医学科学院,北京协和医学院,北京协和医院内分泌科,国家卫生健康委员会内分泌重点实验室,疑难重症及罕见病国家重点实验室,北京100730

出　　处：《中华内科杂志》2022年第6期703-707,共5页Chinese Journal of Internal Medicine

基　　金：2020中国糖尿病英才研究项目(2020-N-01-10)。

摘　　要：患者女性, 22岁。自青春期起逐渐出现多毛、黑棘皮征、阴蒂增大及月经紊乱等临床表现。曾多次查雄激素水平明显升高。我院住院期间发现存在严重胰岛素抵抗、糖尿病。胰岛素受体基因检测提示存在致病性突变, 诊断为A型胰岛素抵抗综合征。予二甲双胍治疗后患者黑棘皮征有明显缓解, 血糖控制满意, 月经周期恢复。A 22-year-old female has complained of hirsutism,acanthosis nigricans,enlarged clitoris,and menstrual disorders since puberty.Laboratory examinations revealed hyperandrogenemia.Severe insulin resistance and diabetes were found during hospitalization in our hospital.She was diagnosed with type A insulin resistance syndrome finally.After treatment with metformin,the acanthosis nigricans was significantly relieved,blood glucose was controlled satisfactorily,and the menstrual cycle was restored.

关 键 词：雄激素增多症 胰岛素抗药性 女性 

分 类 号：R589[医药卫生—内分泌]