【摘要】 目的 总结胰岛素类似物过敏的临床表现、治疗及预后，以期指导临床实践。 方法 总结我院2002年12月至2014年12月诊治的胰岛素类似物过敏病例14例，检索美国PubMed、荷兰Sciencedirect、CNKI和万方数据库，获得文献报道病例26例，分析临床特点、诊治过程及治疗与临床表现的关系。 结果 38例提供过敏前胰岛素类似物使用时间，89.5%过敏发生在用药21 d内。10例对多种胰岛素类似物过敏，2例发生全身过敏反应。提供治疗方案的39例，3例单纯抗过敏治疗，11例更换胰岛素，12例停用胰岛素，13例采用脱敏治疗。对治疗方案与过敏前胰岛素使用时间进行Spearman分析(r=0.441，P=0.006)。 结论 胰岛素类似物过敏多在应用后短期内发生，严重者威胁生命。过敏前的胰岛素使用时间对过敏后治疗方案的选择有提示作用。

　　【关键词】 胰岛素类似物;过敏反应;糖尿病

　　Allergic reaction to insulin analogue: 14 cases report and literature review YUAN Xiao-yong,GAO Ying,ZHANG Jun-qing, et al. Department of Endocrinology,Peking University First Hospital,Beijing 100034,China

　　Corresponding author: ZHANG Jun-qing, E-mail: junqing-zhang@medmail.com.cn

　　【Abstract】 Objective To explore the clinical characteristics, treatment and prognosis of allergic reaction to insulin analogue. Methods Clinical characteristics, treatment and the relationship between treatment and clinical characteristics were analyzed in 14 cases treated in our hospital during December 1, 2002 to December 31, 2014 and 26 cases obtained from Pubmed, Sciencedirect, CNKI and WANFANG DATA. Results The duration of insulin analogue treatment before allergic reaction were provided in 38 cases and the median time of the duration was 2.5 days (0，450 days). 89.5% allergic reactions occurred within 21 days after insulin analogue initiation. 10 patients suffered from allergic reaction to a variety of insulin analogues. General allergic reaction occurred in 2 patients. 39 patients reported their treatments on allergic reactions: Insulin analogue was continued when anti-allergic drug applied in 3 patients, changed in 11 patients, and stopped in 12 patients, and desensitization of insulin was performed in 13 patients. Treatment of insulin allergy and duration of insulin treatment before allergy were analyzed by Spearman analysis (r=0.441, P=0.006). Conclusion Most of allergic reactions occur within a short period after insulin analogue initiation. Some even are life-threatening. Awareness of duration of insulin treatment before allergic reaction will be helpful for treatment to allergy.

　　【Key words】 Insulin analogue; Allergic reaction; Diabetes mellitus