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外源性胰岛素抗体综合征三例报道

来自:中国糖尿病杂志  编辑:肖靖 李梅欣 郑欣|点击数:|2015-06-17

  ·病例报告·

  【摘要】 目的 探讨外源性胰岛素抗体综合征(EIAS)的临床特点。 方法 回顾性分析3例住院EIAS患者的一般资料和实验室指标。 结果 EIAS患者年龄63~81岁,糖尿病病程10~22年,低血糖发作1例,发作时间无规律;均无自身免疫病史和含巯基药物接触史;血清ICA、GADAb均(-),IAA均强阳性(>100);血清胰岛素水平均升高,但与C-P水平不匹配;调整为口服药或减少胰岛素次数后,血糖控制均改善。 结论 高胰岛素血症伴或不伴低血糖的T2DM患者,如检测血清胰岛素浓度与C-P水平不匹配,需检测胰岛素抗体,并考虑EIAS的可能性,必要时调整为口服药治疗可改善血糖控制。

  【关键词】 胰岛素抗体;外源性胰岛素;高胰岛素血症;外源性胰岛素抗体综合征

  【Abstract】 Objective To explore the clinical characteristics of exogenous insulin antibody syndrome. Methods The general data and laboratory index of 3 EIAS inpatients were retrospectively analyzed. Results EIAS patients age was 63~81 years old and courses were 10~22 years. One patient with no regular pattern of the onset time of hypoglycemia; All subjects had no history of autoimmune disease and using the drugs containing the sulfydryl group; the serum cellular antibody and glutamic acid decarboxylase antibody were all negative, and insulin autoantibody were all positive; the serum insulin levels were high in these patients, but disproportional with the C-P level; through adjusting for oral hypoglycemic drugs and discontinuing of insulin or reducing the doses of insulin, blood glucose control has were improved. Conclusion It’s necessary to measure insulin antibody and consider the possibilities of EIAS,if patients with hyperinsulinemia and disproportional with the serum C-P levels, adjusting for oral hypoglycemic drugs and discontinuing of insulin or reducing the doses of insulin can improve glucose control.

  【Key words】 Insulin antibody; Exogenous insulin; Heperinsulinemia; Exogenous insulin antibody syndrome

上一篇:胰岛素自身抗体影响胰岛素测定及作用的临床及实验分析二例报道 下一篇:成人隐匿性自身免疫性糖尿病患者晚餐前高血糖与胰岛β细胞功能的相关性研究

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