老年外源性胰岛素抗体综合征一例并文献复习  

Exogenous insulin antibody syndrome in an elderly patient:a case report and literature review

作　　者：冯鑫源 张丽娜[2] 郭立新[2] 潘琦 Feng Xinyuan;Zhang Lina;Guo Lixin;Pan Qi(Graduate School of Peking Union Medical College,Chinese Academy of Medical Sciences,Department of Endocrinology,Beijing Hospital,National Center for Gerontology,Institute of Gerontology,Chinese Academy of Medical Sciences,Beijing 100730,China;Department of Endocrinology,Beijing Hospital,National Center for Gerontology,Institute of Gerontology,Chinese Academy of Medical Sciences,Beijing 100730,China)

机构地区：[1]北京协和医学院研究生院,中国医学科学院,北京医院内分泌科,国家老年医学中心,中国医学科学院老年医学研究院,北京100730 [2]北京医院内分泌科,国家老年医学中心,中国医学科学院老年医学研究院,北京100730

出　　处：《中华老年医学杂志》2023年第12期1442-1446,共5页Chinese Journal of Geriatrics

基　　金：北京市科技计划(Z221100007422007)。

摘　　要：对于糖尿病特别是老年糖尿病患者,胰岛素作为控制高血糖的重要治疗手段被广泛应用。然而因老年糖尿病患者大剂量胰岛素使用率高、更易合并胰岛素抵抗及治疗不规范等问题,使用外源性胰岛素时诱导产生的胰岛素自身抗体与严重胰岛素抵抗、顽固性高血糖和低血糖相关,称为外源性胰岛素抗体综合征。低血糖时可存在与C肽不匹配的高胰岛素水平,为控制血糖增加胰岛素剂量可能适得其反,需要及时明确诊断并对降糖方案做出个体化调整,以免造成严重后果。For diabetes patients.especially elderly diabetes patients.insulin is widely used as an important treatment to control hyperglycemia.However,since a high percentage of elderly diabetes patients use high doses of insulin.it is common to incur issues such as increased insulin resistance and inappropriate treatment.Exogenous insulin-induced autoantibody production is associated with severe insulin resistance and refractory hyperglycemia and hypoglycemia and is referred to as exogenous insulin antibody syndrome.With hypoglycemia.high insulin levels may be inconsistent with C-peptide levels.Increasing the dose of insulin to control blood glucose may be counterproductive.It is necessary to quickly and accurately make a diagnosis and make personalized adjustments to the glucose-lowering regimen to avoid serious consequences.

关 键 词：胰岛素抗体 低血糖症 糖尿病 2型 外源性胰岛素抗体综合征 

分 类 号：R587.1[医药卫生—内分泌]