糖尿病患者外源性胰岛素诱导胰岛素抗体产生的临床意义

在某些糖尿病患者使用某些外源性胰岛素或胰岛素类似物后，诱导机体产生相应的胰岛素抗体（insulinanti．body，lAb），当血中胰岛素自身抗体（IAA）的滴度及与胰岛素结合力达到一定水平后可以改变胰岛素的药代动力学，出现血糖波动、胰岛素抵抗或低血糖等临床表现。IAA的产生与胰岛素的氨基酸序列、胰岛素剂型、给药方式和患者自身的遗传因素相关。近年来随着临床上使用胰岛素治疗的糖尿病患者日益增多，发现外源性胰岛素或胰岛素类似物诱导IAA阳性并发生临床表现的糖尿病患者有增多的趋势。本文就外源性胰岛素或胰岛素类似物诱导IAA的特征、影响因素及外源性胰岛素或胰岛素类似物诱导IAA产生患者的临床表现和处理做一综述。．

Clinical significance of insulin antibody induced by exogenous insulin in diabetic patients

Exogenous insulin or insulin analogue may induce human body to produce insulin antibodies （IAb）. It may change the insulin pharmacokinetics when insulin autoantibody （IAA） titers and insulin binding capacity reach a certain level, showing the blood sugar fluctuations, insulin resistance or hypoglycemia and other clinical manifestations. The generation of IAA induced by exoge- nous insulin or insulin analogue is thought to be associated with sequence differences of amino acid, insulin＇s dosage form, delivery route and patients＇ genetic factors. In recent years,with increasing diabetic patients during the clinical use of insulin therapy, there is a grow- ing trend of insulin antibody syndrome （IAS）. This paper summarizes the feature and influence factors of insulin antibody, and then in- troduces the clinical feature and treatment of the IAS.