论文部分内容阅读
近年来接受大剂量胰岛素治疗的糖尿病例数增多,慢性胰岛素过量综合征的发生率在小儿重型糖尿病为80～90%,成人重型糖尿病为30%左右。众所周知,胰岛素依赖型糖尿病一昼夜胰岛素剂量平均为0.5～0.8U/kg,如超过1U/kg 即出现低血糖症。不典型或症状不全型低血糖症没有明显的饥饿感,出汗和心动过速症状也较轻,而有精神运动性兴奋,欣快症或谵妄型,运动过度型,精神错乱和反应性皮层兴奋。可表现为无缘无故的狂怒、恐惧、忧虑和攻击等,常见于小儿。接受长效胰岛素治疗的病例,30～40%可能发生无症状的夜间低血糖症,老年人可发生血管障碍(脑血循环障碍和心绞痛发作)。该综合征的发病机制:胰岛素过量导致血糖过低,作为对低血糖的应激反应,所有的抗胰岛素激素包括高血糖素、儿茶酚胺、糖皮质激素、生长激素和
In recent years, receiving high-dose insulin therapy increased the number of cases of diabetes, the incidence of chronic insulin overdoses in children with severe diabetes mellitus is 80 to 90%, adult diabetes is about 30%. As we all know, insulin-dependent diabetes mellitus a day and night dose of insulin average 0.5 ~ 0.8U / kg, such as more than 1U / kg hypoglycemia. Atypical or symptomatic hypoglycemia no obvious hunger, sweating and tachycardia symptoms are mild, and there are psychomotor excitement, euphoria or delirium, hyperactivity, delirium and reactive cortex Excited. Fury, fear, anxiety and attack can be manifested for no reason, common in children. Patients receiving long-acting insulin therapy may experience asymptomatic nocturnal hypoglycemia in 30-40% and vascular disorders (cerebral circulatory disorders and angina pectoris) in the elderly. The pathogenesis of the syndrome: Insulin overload leads to hypoglycemia, and as a stress response to hypoglycemia, all anti-insulin hormones include glucagon, catecholamines, glucocorticoids, growth hormones and