贵州医科大学学报

2015, v.40;No.176(05) 504-506+510

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胰岛β细胞瘤12例临床分析
Clinical Analysis of Twelve Cases of Insulinoma

刘成;刘兴贵;徐淑静;
LIU Cheng;LIU Xinggui;XU Shujing;Guiyang Medical College;Department of Endocrinology,Affiliated Hospital of Guiyang Medical College;Department of Hepatobiliary Surgery,Affiliated Hospital of Guiyang Medical College;

摘要(Abstract):

目的:探讨胰岛β细胞瘤的临床特点,避免误诊误治。方法:外科手术治疗并经病理确诊的12例胰岛β细胞瘤患者,分析其影像学检查资料、空腹血糖、胰岛素、C肽水平、胰岛素/血糖比值及治疗结果。结果:病理确诊为单发肿瘤11例,多发1例;术前B超检查10例,阳性4例(40%),CT检查10例,阳性9例(90%),核磁共振成像(MRI)检查4例,阳性3例(75%);所有患者空腹血糖范围为0.25~2.90 mmol/L,12例均<3.0 mmol/L;胰岛素水平为4.63~82.09 m IU/L,12例>3.0 m IU/L;C肽0.26~1 100.71 pmol/L,>200 pmol/L者4例;低血糖发作时胰岛素释放指数>0.4者7例(58%),5例胰岛素释放指数小于0.4,占总例数的42%;本组患者均为良性肿瘤,手术后均治愈。结论:当患者反复出现低血糖反应或不明原因神经精神症状时,应监测血糖,及时发现低血糖症并追究低血糖发生的原因,避免漏诊及误诊胰岛素β细胞瘤。
Objective: To explore the clinical signs and features of insulinoma in order to avoid misdiagnosis and therapeutic error. Methods: Twelve patients with insulinoma confirmed by means of surgical resection and pathology were enrolled in this study. The clinical data such as fasting blood-glucose,plasma insulin level,c-peptide level,insulin-glucose ratio and imaging examination and therapeutic outcome were analyzed. Results: Eleven cases of single tumor and 1 case of multiple tumors were diagnosed by pathology. Before surgery 10 cases were examined with type-B ultrasonic check,the positive rate being 40%; 10 cases were examined with CT,the positive rate being 90%; four cases were examined with MRI,the positive rate being 75%. All patients' fasting blood-glucose ranged from0. 25 to 2. 90 mmol / L,all the cases were below 3. 0 mmol / L. All patients' plasma insulin levels ranged from 4. 63 to 82. 09 m IU / L,of which 12 patients' plasma insulin levels were > 3. 0 m IU / L. 12 patients' c-peptide level ranged from 0. 26 to 1 100. 71 pmol / L,of which 4 patients' c-peptide level was> 200 pmol / L. When hypoglycemia occurred,there were 7 cases whose insulin release index was >0. 4( 58 %) and 5 cases whose < 0. 4( 42 %). All the above cases were benign tumors and cured by means of surgery. Conclusion: When the clinical manifestations of hypoglycemia occur repeatedly or there are unexplained symptoms of neuro-psychiatric disorders,plasma glucose should be monitored so that hypoglycemia can be discovered in time and avoid missed diagnosis and misdiagnosis of insulinoma.

关键词(KeyWords): 胰岛β细胞瘤;血糖;胰岛素;C肽
Insulinoma;blood glucose;insulin;C-peptide

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作者(Author): 刘成;刘兴贵;徐淑静;
LIU Cheng;LIU Xinggui;XU Shujing;Guiyang Medical College;Department of Endocrinology,Affiliated Hospital of Guiyang Medical College;Department of Hepatobiliary Surgery,Affiliated Hospital of Guiyang Medical College;

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DOI: 10.19367/j.cnki.1000-2707.2015.05.021

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