| 张星星,姜慧苗,马建梅.胰岛素自身免疫综合征 3例报告及文献复习[J].安徽医药,2021,25(9):1762-1765. |
| 胰岛素自身免疫综合征 3例报告及文献复习 |
| Three cases of insulin autoimmune syndrome and literature review |
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| DOI：10.3969/j.issn.1009-6469.2021.09.015 |
| 中文关键词: 胰岛素自身免疫综合征 低血糖 胰岛素自身抗体 |
| 英文关键词: Insulin autoimmune syndrome Hypoglycemia Insulin autoantibody |
| 基金项目:陕西省教育厅 2018年度专项科学研究计划( 18JK0678) |
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| 中文摘要: |
| 目的总结分析国内胰岛素自身免疫综合征( insulin autoimmune syndrome，IAS)病人的临床资料，以期提高临床对 IAS的认识。方法对 2013年 6月至 2018年 12月于西安高新医院确诊为 IAS的 3例病人和 2009年 6月至 2019年 6月于各大数据库中检索到关于 IAS的 87例国内个案报道进行回顾性分析，总结其病史、临床表现、生化特点、治疗及预后等临床资料。结果通过对 90例 IAS病例进行回顾性统计分析，数据显示 IAS男女比例 1∶2，女性 IAS病人比例高于男性病人( P<0.05)，且发病年龄主要集中在 >39~59岁；甲巯咪唑所致 IAS所占比例 52.22%，高于其他诱发药物( P<0.001)；低血糖发作时 VPG(2.05± |
| 英文摘要: |
| Objective To summarize and analyze the clinical data of patients with insulin autoimmune syndrome (IAS), so as to improve the clinician's understanding of IAS. Methods A retrospective analysis was made of 3 confirmed cases in Endocrinology Department of Xi'an Gaoxin Hospital from June 2013 to December 2018, and 87 cases reported in domestic literatureretrieval retrievedfrom respective databases from June 2009 to June 2019. Their medical history, clinical manifestations, biochemical parameters, treatment and prognosis were summarized and analyzed.Results Of the 90 IAS cases, the ratio of male to female patients was 1∶2, which suggested that the incidence of female IAS patients was higher than male patients (P<0.05). The patients' age of onset was mainly in the group of >39-59 years old. The proportion of IAS induced by methimazole was 52.22%, higher than that induced by other drugs (P< 0.001). The mean value of venous plasma glucose (VPG) during hypoglycemia onset was (2.05±0.67) mmol/L. Glucocorticoid therapywas effective, when hypoglycemia symptom was poorly controlled. During the 3-month follow-up after treatment, the hypoglycemic episodes of 66 cases had disappeared. And among them, 29 IAS patients received glucocorticoid therapy. But there was no statistical difference in the time of IAA turning negative between glucocorticoid therapy and non-glucocorticoid therapy (P>0.05).Conclusion IAS is inclined to occur in female, and the age group of onset is mainly in the range of >39-59 years old. Methiazole is the most commondrug that induces IAS. Therapeutically, a low dose of glucocorticoids can be used when necessary to achieve satisfactory treatment effect. |
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