自发性低血糖一例并文献复习  

Spontaneous Hypoglycemia: A Case Report and Literature Review

作　　者：薛晓霞 刘璐[1] 胡松[1] 冯媛媛 宫婷 

机构地区：[1]青岛大学附属医院老年医学科,山东 青岛 [2]中国人民解放军海军第九七一医院保健科,山东 青岛

出　　处：《临床医学进展》2020年第8期1621-1624,共4页Advances in Clinical Medicine

摘　　要：目的:了解自发性低血糖的病因及诊断,提高对非糖尿病患者药物性低血糖的认识。方法:详细回顾分析一例自发性低血糖患者的病例资料,并复习国内外相关文献。结果:患者为老年男性,反复乏力伴意识不清1周,查静脉血糖1.4 mmol/L,进食或输注葡萄糖后好转,既往无糖尿病病史。完善饥饿实验、口服葡萄糖耐量(OGTT)延长实验均未诱发出低血糖,皮质醇节律、C肽、胰岛素原、胰岛素自身抗体、上腹部增强CT等未见明显异常,后追问患者病史,患者长期口服“德国黑倍、壮阳药”等保健品,考虑药物性低血糖,停用1周后,未出现低血糖,出院后随访1月余,未再次发作低血糖,明确诊断为药物性低血糖。结论:非糖尿病患者自发性低血糖在临床中较少见,病因及诊断仍为一大难题,因此明确自发性低血糖的病因及诊断至关重要,结合本例回顾并复习相关文献,以提高对自发性低血糖的认识。Objective: To understand the etiology and diagnosis of spontaneous hypoglycemia and improve the understanding of drug-induced hypoglycemia in non-diabetic patients. Methods: A case of spontaneous hypoglycemia was analyzed in detail, and the related literature at home and abroad was reviewed. Results: The patient was an old man with repeated fatigue and unconsciousness for one week. The venous blood glucose was 1.4 mmol/l. The patient improved after eating or infusion of glucose. There was no previous history of diabetes. No hypoglycemia was induced in the hunger test and OGTT prolongation test. No obvious abnormality was found in cortisol rhythm, C-peptide, proinsulin, insulin autoantibody, and enhanced CT of upper abdomen. After questioning the patient’s medical history, the patient took health care products such as “German black times, aphrodisiac” for a long time. Considering drug-induced hypoglycemia, no hypoglycemia occurred after 1 week of discontinuation. After discharge, the patient was followed up for more than 1 month. There was no recurrence of hypoglycemia, and he was clearly diagnosed as drug-induced hypoglycemia. Conclusion: Spontaneous hypoglycemia in non-diabetic patients is rare in clinical practice. The etiology and diagnosis are still a big problem, so it is very important to identify the etiology and diagnosis of spontaneous hypoglycemia, combined with this case to review and review the relevant literature, so as to improve the understanding of spontaneous hypoglycemia.

关 键 词：低血糖 自发性低血糖 药物性低血糖 病因 

分 类 号：R58[医药卫生—内分泌]