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例1女,32岁,1996年5月20日以反复清晨出汗、头昏2月,昏迷16小时主诉入院。3天前早晨昏迷2～10小时后症状自行缓解。门诊血糖0.7mmol/L,经静推葡萄糖后神志清醒。体检:T 37.4℃,P 24次/分,R 20次/分,BP 16/11kPa,神志清楚,无肝掌及蜘蛛痣,心肺无异常,肝脾未触及,神经系统检查无异常。入院后空腹血糖、OGTT、胰岛素释放指数和修正指数提示胰岛素分泌过高(见下表)。
Example 1 Female, 32 years old, May 20, 1996 to repeated sweating morning, dizziness in February, coma 16 hours admitted to the main complaint. 3 days ago morning coma symptoms 2 to 10 hours to ease themselves. Outpatient blood glucose 0.7mmol / L, after conscious intravenous glucose conscious. Physical examination: T 37.4 ℃, P 24 beats / min, R 20 beats / min, BP 16 / 11kPa, conscious, no liver palms and spider nevus, no abnormal heart and lung, liver and spleen not touched, nervous system examination no abnormalities. Fasting blood glucose, OGTT, insulin release index and modification index after admission suggest that insulin secretion is excessive (see table below).