摘要目的:总结并分析胰岛素自身免疫综合征（IAS）和外源性胰岛素抗体综合征（EIAS）的临床特征，探讨这两种综合征的异同点。方法:选取2006年1月至2018年3月在解放军总医院住院的22例临床诊断为IAS（ n=13）和EIAS（ n=9）的患者作为研究对象，回顾性分析两组患者的年龄、性别、体质指数（BMI）、空腹血糖、餐后2 h血糖、空腹C肽、餐后2 h C肽、空腹胰岛素、餐后2 h胰岛素、糖化血红蛋白及低血糖自发缓解比例。采用 t检验或χ2检验比较两组患者的临床特征。 结果:IAS组及EIAS组年龄、男女比例和BMI差异均无统计学意义（ P>0.05），空腹血糖［（4.2±1.8）比（10.2±5.1）mmol/L， t=3.254， P<0.01］、餐后2 h血糖［（9.6±4.9）比（19.3±6.6）mmol/L， t=5.240， P<0.01］和HbA 1c ［（6.9±1.9）%比（12.6±1.3）%， t=4.454， P<0.01］差异存在统计学意义，但两组空腹胰岛素［923.5（287.1，3 714.4）比480.0（278.9，851.9）mU/L］、空腹C肽［5.1（3.3，13.2）比4.1（1.8，6.8）ng/ml］、负荷后2 h胰岛素［4 069.0（835.5，6 921.3）比968.7（381.1，3 113.0）mU/L］、餐后2 h C肽［14.6（12.3，24.4）比7.6（2.6，16.3）ng/ml］、空腹胰岛素/C肽摩尔比值（5.3±6.6比3.4±2.2）和负荷后2 h胰岛素/C肽摩尔比值（5.7±6.0比4.3±3.3）差异无统计学意义（均 P>0.05）。两组患者低血糖自发缓解的比例［69%（9/13）比67%（6/9）］差异亦无统计学意义（ P>0.05）。 结论:IAS与EIAS除了血糖存在差异，其人口学、胰岛素、C肽、自发缓解率、治疗策略和预后均无明显差异。

abstractsObjective:To compare clinical characteristics between the types of insulin antibody related syndromes-insulin autoimmune syndrome (IAS) and exogenous insulin antibody syndrome (EIAS).Methods:A total of 22 patients diagnosed with IAS ( n=13) or EIAS ( n=9) were recruited from Chinese PLA General Hospital between January 2006 and March 2018. A retrospective analysis was conducted using their clinical characteristics such as age, gender, body mass index (BMI), fasting plasma glucose, postprandial plasma glucose, fasting serum insulin, post load serum insulin, fasting serum C-peptide, post load serum C-peptide, glycated hemoglobin A 1c (HbA 1c) and spontaneous remission rates of hypoglycemia which were compared with t test or chi square test. Results:A total of 22 patients were included for final analysis. There were no significant differences in age, male female ratio and BMI between the two groups (all P>0.05). There were significant differences in fasting plasma glucose [(4.2±1.8) vs (10.2±5.1) mmol/L, t=3.254, P<0.01], postprandial plasma glucose [(9.6±4.9) vs (19.3±6.6) mmol/L, t=5.240, P<0.01] and HbA 1c [(6.9±1.9)% vs (12.6±1.3)%, t=4.454, P<0.01] between IAS and EIAS groups. Otherwise, there was no difference in fasting serum insulin [923.5 (287.1, 3 714.4) vs 480.0 (278.9, 851.9) mU/L], C-peptide [5.1 (3.3, 13.2) vs 4.1 (1.8, 6.8) ng/ml], insulin/C-peptide molar ratio (5.3±6.6 vs 3.4±2.2) and post load serum insulin [4 069.0 (835.5, 6 921.3) vs 968.7 (381.1, 3 113.0) mU/L], C-peptide [14.6 (12.3, 24.4) vs 7.6 (2.6, 16.3) ng/ml] and insulin/C-peptide molar ratio (5.7±6.0 vs 4.3±3.3) between IAS and EIAS groups (all P>0.05). There was no significant difference in the spontaneous remission rate of hypoglycemia between the two groups [69% (9/13) vs 67% (6/9), P>0.05]. Conclusion:There are no significant differences in demographic and insulin, C-peptide, spontaneous remission rates, treatment strategy and prognosis except plasma glucose between IAS and EIAS.