婴儿持续性高胰岛素性低血糖症的误诊分析

Analysis of the Misdiagnosis of Persistent Hyperinsulinemic Hypoglycemia of Infancy

目的 提高对婴儿持续性高胰岛素性低血糖症的认识 ,减少误诊。方法 对 3例被误诊的婴儿持续性高胰岛素性低血糖症进行分析。结果 3例均有惊厥表现 ,因忽略血糖检查 ,分别被误诊为宫内中枢神经系统感染、颅内出血和癫痫。入院后常规行血糖检查发现低血糖 ,再进一步检查发现高胰岛素血症。结论 对于婴儿惊厥起病者 ,应常规行血糖检查 ,持续低血糖者 ,再行血胰岛素、尿酮检查 ,尽早发现婴儿持续性高胰岛素性低血糖症。

Objective To better understand persistent hyperinsulinemic hypoglycemia of infancy and to reduce the misdiagnosis of this disease.Methods Three cases of misdiagnosised persistent hyperinsulinemic hypoglycemia of infant were studied by retrospective analysis.Results Convulsion occurred in all three cases.They were misdiagnosed as central nervous system infection, intracranial hemorrhage, epilepsy, respectively, because of lack of examination of blood glucose. Hypoglycemia was found in three cases after the routine examination of hospitalization.Three cases were found hyperinsulinism after further examination.Conclusion Blood glucose should be examined in infants with convulsion. If hypoglycemia was persistent ,blood insulin and urine ketones should be also examined in order to early diagnose this dieease.