临床资料 男性,64岁,退休,因不省人事20分钟于1997年4月12日1时40分急诊留观;患者近半个月来夜间常有饥饿感,尤以凌晨明显,常因饥饿醒来后周身乏力、头晕、冷汗、饥饿难以忍受,须进食或冲服糖水症状方可缓解至消失;白天易饿,进食较前为大.以上情况规律出现,且渐加重,体重无明显变化;此前曾3次查空腹血糖均正常.本次起病突然,不省人事、既往无糖尿病、高血压、冠心病及肝炎、胃病史.查体 T36,5℃,P116次/分,R 24次/分,BP 12/7KPa,偏瘦.面色苍白,四肢湿冷.浅昏迷状;心肺无特殊,肝脾助下未及,无叩痛,全腹未扪及包块,病理征阴性.快速血糖 Clinical data: Male, 64 years old, retired, left unconscious for 20 minutes at 1:40 am on April 12, 1997. The patient often had hunger during the last half-month, especially in the early hours of the morning, often due to hunger. After waking up, the whole body is fatigued, dizzy, cold and hungry. It is unbearable to eat or blunt the symptoms of sugar syrup. It is easy to be hungry during the day and the food is larger than before. The above conditions are regular and gradually increase, and there is no obvious change in body weight. Previously had 3 times to check the fasting blood glucose is normal. This onset suddenly, unconscious, has not had diabetes, high blood pressure, coronary heart disease and hepatitis, stomach history. Physical examination T36, 5°C, P116 times/minute, R 24 times /, BP 12/7KPa, thin. pale, cold limbs. shallow coma; no special cardiopulmonary, liver and spleen to help the next, no pain, no full abdomen and mass, negative pathological signs.