胰岛素瘤患者糖耐量及胰岛素释放曲线特点分析

Analysis of OGTT glucose tolerance curve and insulin releasing curve in patients with insulinoma

目的 通过总结经术后病理证实为胰岛素瘤患者的临床特征及口服葡萄糖耐量试验(OGTT)结果,分析其糖耐量曲线特点及其与临床特征的关系,同时分析不同糖耐量曲线患者的胰岛素释放曲线特点、胰岛素抵抗及胰岛P细胞功能情况,为胰岛素瘤的临床诊治提供帮助。方法 回顾性分析经术后病理证实为胰岛素瘤的83例患者的OGTT结果,绘制糖耐量及胰岛素释放曲线,并计算胰岛素抵抗指数、胰岛素敏感指数、胰岛素生成指数、血糖处置指数DI_(120)等指标。根据OGTT结果分为四组,四组间均数比较采用单因素方差分析,组间率的比较采用卡方检验。结果 糖耐量曲线分为曲线低平型、基本正常型、糖耐量减低型、糖尿病型,四组间临床特征差异无显著性。结论 对于既往合并糖尿病或糖耐量受损的低血糖患者,或单纯糖耐量曲线符合糖耐量低减或糖尿病的低血糖症患者,仍需仔细除外胰岛素瘤。

Objective To summarize the clinical features and OGTT in patients with insulinoma. Method A retrospec- tive analysis of patients with insulinoma from 2012 to 2016 in Peking Union Medical College Hospital, rendering the glucose tolerance and insulin releasing curve, and calculate the HOMA-R, ISI, AI30/AG30, and DI120 index. The pa- tients were divided into 4 groups, the average between 4 groups were compared using single factor analysis of vari- ance, the chi square test was used to compare the rates between groups. Result There were no significant differences in the clinical features between 4 groups. Conclusion For hypoglycemia patiens with pre-existing diabetes or im- paired glucose tolerance, or OGTT showing impaired glucose tolerance or diabetes, careful exception for Insulinoma is still needed.