胰岛功能指标在胰岛素瘤与胰岛素自身免疫综合征中比较分析

目的:比较分析不同胰岛功能指标在胰岛素瘤和胰岛素自身免疫综合征（IAS）中的诊断价值。方法:回顾性分析我院2005年1月-2019年3月明确诊断的胰岛素瘤和IAS病例，比较分析胰岛素（INS）、胰岛素释放指数（IRI）、胰岛素释放修正指数（修正IRI）、C肽、C肽释放指数（CPI）、C肽释放修正指数（修正CPI）、胰岛素/C肽在两组诊断价值以及低血糖发作时胰岛素与C肽相关性研究。结果:胰岛素瘤组24例，IAS组9例，各指标在胰岛素瘤组和IAS组中均有差异。IAS组INS、IRI、修正IRI、C肽、CPI、修正CPI、胰岛素/C肽都高于胰岛素瘤组（均P<0.01）。低血糖发作时，IAS组INS与C肽之间相关性不显著，在胰岛素瘤组中相关性为0.695（P<0.01）。结论:利用各胰岛功能指标在胰岛素瘤和IAS中的差异表达，有助于提高胰岛素瘤和IAS在临床中的鉴别诊断。

Comparative analysis of islet function indices in insulinoma and insulin autoimmune syndrome

Objective: To evaluate the diagnostic value of different islet function indices in insulinoma and insulin autoimmune syndrome（IAS）. Methods: The clinical date of patients with insulinoma and insulin autoimmune syndrome were retrospectively analyzed from January 2005 to March 2019. The diagnostic value of insulin (INS), insulin release index (IRI), amended IRI, C-peptide, CPI, amended CPI, insulin/C-peptide in insulinoma and IAS were compared and the relationship between insulin and C-peptide during hypoglycemia were compared. Results: There were 24 cases in insulinoma group and 9 cases in IAS group，each index had significant differences between the two groups. The data of two groups showed that the expression level of insulin, insulin release index, amended IRI, C-peptide, CPI, amended CPI, insulin/C-peptide of the IAS group were higher than those in the insulinoma group(all P<0.05). There was no significant correlation between INS and C-peptide in IAS group when hypoglycemia，and the correlation in insulinoma group was 0.695, P<0.01. Conclusion: The differential expression of various islet function indexes in insulinoma and IAS is helpful to improve the differential diagnosis of insulinoma and IAS.