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目的 探讨非胰岛素瘤胰源性低血糖综合征(NIPHS)的临床特点、定性定位诊断方法及治疗与预后.方法 回顾性分析3例NIPHS患者临床资料.结果 3例患者均为女性,均有空腹低血糖,均符合内源性高胰岛素血症诊断.1例饥饿试验阳性,3例术前影像学检查均未发现胰岛素瘤证据,其中第2例行68Ga-exendin4-PET/CT示胰尾部代谢轻度增高.2例行SACST,1例为阳性,另1例钙刺激后胰岛素较基线值升高,但未达2倍以上,该例行胰腺大部切除+脾切除术,术后病理示胰岛细胞增生,术后低血糖未缓解.结论NIPHS的诊断需符合内源性高胰岛素血症、SACST阳性、术前影像检查阴性,病理支持胰岛细胞增生,但临床表现仍存在较大异质性,有些临床表现与胰岛素瘤存在重叠,临床须仔细鉴别.若术前影像学难以确诊,且手术指征明确,可考虑行外科探查术协助诊断与治疗.“,”Objective To investigate the clinical features of NIPHS. Method The clinical data of 3 patients with NIPHS were analyzed retrospectively.Result All the 3 patients were female,and all of them had fasting hypoglycemi-a.One case was positive in the 72h fasting test.No evidence of insulinoma was found in the preoperative imaging examinations of all the 3 cases,but 68Ga-exendin4-PET/CT showed a slight metabolism increase in pancreatic tail in the second case. SACST was applied in 2 cases,one case were positive,the other was negative,but this patient underwent subtotal pancreatic splenectomy,postoperative pathology showed islet cell hyperplasia. Conclusion The diagnosis of NIPHS should accord with endogenous hyperinsulinemia,positive SACST,negative imaging of preopera-tive imaging,and islet cell hyperplasia.But there is still large heterogeneity,and overlapping with insulinoma,which needs careful differention.