胰岛素及C肽监测在低血糖昏迷病因诊断及治疗中的价值

目的探讨胰岛素及C肽水平监测在低血糖昏迷诊断治疗中的价值。方法对16例低血糖昏迷患者，除按低血糖昏迷诊疗常规处理外，同时进行血清胰岛素和C肽检测，在治疗过程中监测血糖和血清胰岛素水平变化以指导治疗。结果10例糖尿病服用磺脲类降糖药的低血糖昏迷患者中8例血清胰岛素及C肽水平均增高。3例酒精中毒患者血清胰岛素及C肽水平亦增高。1例非糖尿病患者血清胰岛素和C肽水平严重增高，经B超及CT检查诊断为胰岛素瘤。全部患者经吸氧、50％葡萄糖注射后续10％葡萄糖液静脉滴注0．5-4h后逐渐清醒，血糖逐渐恢复正常水平。前述磺脲类降糖药过量患者，其血清胰岛素水平分别在3～5d后降至正常范围，之后根据血糖逐步恢复降糖药物治疗，并根据血清胰岛素水平调整降糖药物剂量，随访观察患者未再发生低血糖发作。结论对低血糖患者进行血胰岛索和C肽水平检测，有助于病因诊断和提高抢救治疗效果和防止再次和反复发生低血糖昏迷。

Value of serum insulin and C-peptide monitoring in diagnosis and treatment of hypoglycemic coma

Objective To investigate the value of serum insulin and C-peptide monitoring in the diagnosis and treatment of hypoglycemic coma.Methods 16 patients with hypoglycemic coma received routine examination and treatment according to hypoglycemic coma managing protocol,meanwhile received serum insulin and C-peptide,and blood glucose monitoring during treatment.Results Serum insulin and C-peptide level increased in 8 of 10 patients of hypoglycemic coma treated with sulfonylureas drugs and 3 patients of alcoholism....