论文部分内容阅读
胰岛素自身免疫综合征(IAS)又称自身免疫性低血糖(AIH),是一种罕见类型的低血糖症,1970年由日本Hirata首次报道,故又称Hirata病。临床以反复发作的低血糖、高胰岛素血症及胰岛素自身抗体(IAA)或胰岛素受体抗体阳性为表现]。AIH在日本被列为自发性低血糖症的第3大病因。国内只有少数病例报道,无相关流行病学资料。现将1例IAS患者动态血糖监测结果报道如下。一、病例资料患者女,67岁,2009年6月初无诱因出现易饥,下午3～4时感到饥饿明显,餐后有口干、多饮、多尿症状。经中药治疗后症状无改善,后午后自行加餐,症状可缓解。2009年7月初,患者再次感饥饿感明显,同时伴出汗增多,在此基础上出现夜间饥饿感,饥饿时心悸、出汗、头昏、乏力明显。进食零食或糖水后数分钟症状可缓解。院外多次查空腹血糖(末梢血)(FBG)均偏低,最低为3 mmol/L,餐后2 h血糖(2hBG)升高,最高为16.8 mmol/L,HbA_1c 7.3%。胰腺CT提
Insulin autoimmune syndrome (IAS), also known as autoimmune hypoglycemia (AIH), is a rare type of hypoglycemia, first reported in 1970 by the Japanese Hirata, it is also known as Hirata disease. Clinical manifestations of recurrent hypoglycemia, hyperinsulinemia and insulin autoantibodies (IAA) or insulin receptor antibody positive]. AIH is ranked as the third leading cause of spontaneous hypoglycemia in Japan. Only a few cases of domestic coverage, no relevant epidemiological data. Now IAS patients with dynamic glucose monitoring results reported below. First, the patient information Female, 67 years old, early June 2009 no predisposing to easy hunger, 3 to 4 pm feel hungry, postprandial dry mouth, polydipsia, polyuria symptoms. After treatment of Chinese medicine symptoms did not improve, afternoon meal after dinner, the symptoms can be alleviated. At the beginning of July 2009, the patient again felt a great sense of hunger, accompanied by an increase in sweating. On the basis of this, he experienced hunger at night, palpitation, sweating, dizziness and weakness during starvation. A few minutes after eating snacks or syrup can relieve symptoms. The fasting blood glucose (FBG) was low, with a minimum of 3 mmol / L and a 2 h postprandial blood glucose (2 hBG) increase of 16.8 mmol / L and 7.3% of HbA_1c. Pancreas CT mention