二氮嗪联合奥曲肽治疗先天性高胰岛素血症1例

Therapeutic Method of Congenital Hyperinsulinism by Octreotide and Diazoxide

目的:探讨先天性高胰岛素血症(CHI)的治疗方法,提高该病的救治效果。方法:分析我院收治的1例CHI患儿的临床资料、治疗方法及预后并复习相关文献。结果:患儿反复发作低血糖及抽搐14 d入院,确诊为CHI,单用二氮嗪6 d效果不明显,联合奥曲肽治疗后低血糖得以控制,联合用药20 d后单独口服二氮嗪,血糖维持正常,随访病情稳定。结论:奥曲肽治疗CHI的顽固性低血糖症显效快,与二氮嗪联合使用再序贯以二氮嗪单独给药可以较快控制低血糖症状并维持疗效,防治低血糖性脑损伤,为CHI的内科治疗提供了新的方法和经验,对临床治疗有重要意义。

Objective： To study the treatments and therapeutic effectiveness Congenital hyperinsulinism （CHI）. Methods： The clinical data and therapeutic method of one case with CHI in our hospital were analyzed retrospectively and reviewed. Results： The patient was admitted to hospital because recurrent hypoglycemia and seizures for fourteen days. He was diagnosed as CHI and given medicine treatment. The effectiveness of diazoxide used alone for 6 days was unsatisfactory. The hypoglycemia was alleviated by diazoxide in combination with oetreotide. After twenty days＇ treatment, the administrations were changed to oral diazoxide alone. The blood glucose of patient maintained normally, and conditions were stable. Conclusions： Octreotide affects quickly on hypoglycemia, while diazoxide works slowly. Combination of octreotide and diazoxide, then sequential diazoxide alone was a new effective method for treating CHI.