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[目的]探讨胃癌合并肝转移瘤出现低血糖症的临床特点、可能机制及治疗方法。[方法]回顾分析2例胃癌合并肝转移瘤患者出现低血糖症的临床表现、特点及治疗方法、转归等。[结果]胃癌合并肝转移瘤出现低血糖症的发病率低,出现低血糖症的患者空腹血糖低于正常,且口服葡萄糖后血糖上升慢、波动不明显,空腹C肽、胰岛素低于正常或正常偏低,口服葡萄糖后C肽、胰岛素分泌曲线波动不明显且高峰延迟。[结论]胃癌合并肝转移瘤出现低血糖症此种少见副肿瘤综合征的可能机制主要为合成胰岛素样活性物质big-IGF-2。纠正此种低血糖症最有效的方法为根治原发疾病,完全切除肿瘤。
[Objective] To investigate the clinical features, possible mechanisms and treatment of hypoglycemia in gastric cancer with liver metastases. [Methods] The clinical manifestations, characteristics, treatment methods and outcomes of hypoglycemia in 2 patients with gastric cancer and liver metastases were analyzed retrospectively. [Results] The incidence of hypoglycemia in gastric cancer with hepatic metastases was low, and the fasting blood glucose in patients with hypoglycemia was lower than normal. After oral glucose, the blood glucose rises slowly and the fluctuation is not obvious. The fasting C peptide and insulin are lower than normal or Normally low, C peptide, insulin secretion curve fluctuations after oral glucose was not obvious and the peak delay. [Conclusion] The occurrence of hypoglycemia in gastric cancer with hepatic metastases is a rare mechanism for the synthesis of insulin-like active substance big-IGF-2. The most effective way to correct this kind of hypoglycemia is to cure the underlying disease and completely remove the tumor.