摘要
目的正确判断慢性增殖性血液病导致的低血糖,以指导临床正确治疗。方法对血糖低于2.8mmol.L-1而无任何低血糖症状的7例慢性粒细胞白血病及3例真性红细胞增多症患者,临床上未做任何特殊处理,生化血糖结果回报后同时急查指端血糖,并完善口服葡萄糖耐量试验、C肽释放试验及胰岛素释放试验。结果 10例患者胰岛素、C肽水平均正常,口服葡萄糖耐量试验提示空腹血糖低,但服糖后60、120min血糖均正常;采血后搁置0、30、60、120、180min的血糖值分别为(6.25±0.35)、(95.79±0.46)、(4.78±0.43)、(3.27±0.48)、(1.68±0.54)mmol.L-1,提示血标本搁置时间长可导致血糖检测水平低,证实此10例患者低血糖均为假性低血糖。结论慢性粒细胞白血病及真性红细胞增多症均可以出现假性低血糖,临床上需正确判断,避免盲目治疗。
Objective To correctly judge hypoglycemia induced by chronic proliferative hematonosis to direct clinical treatment.Methods After biochemical blood glucose parameters were obtained,fingertip blood glucose testing was performed in 10 patients with serum glucose levels less than 2.8 mmol·L-1 and without hypoglycemic symptoms（7 cases of chronic myelocytic leukemia and 3 cases of polycythemia rubra vera） who did not receive special treatment.Oral glucose tolerance test,C-peptide releasing test and insulin releasing test were improved to evaluate insulin release and insulin resistance.Results The levels of C-peptide were normal in all patients.Oral glucose tolerance test showed lower fasting blood glucose levels,which returned to normal levels 60 and 120 minutes after sugar treatment.Blood glucose levels were（6.25±0.35）,（95.79±0.46）,（4.78±0.43）,（3.27±0.48） and（1.68±0.54）mmol·L-1after blood samples were set aside for 0,30,60,120 and 180 minutes,respectively.There results demonstrated that long-time blood sample shunt decreased the detection levels of blood glucose and pseudohypoglycemia was confirmed in all the 10 patients.Conclusion Both chronic myelocytic leukemia and polycythemia rubra vera can induce pseudohypoglycemia.Therefore,correct clinical judgment is needed to avoid blind treatment.
出处
《南昌大学学报（医学版）》
CAS
2011年第12期56-58,共3页
Journal of Nanchang University：Medical Sciences
