Objective To investigate clinical characteristics of insulinoma and key points of differential diagnosis of disease causation of hypoglycemia insulinoma in order to reduce misdiagnosed rate. Methods Clinical data of 3 insulinoma patients was retrospectively analyzed. Results One patient was admitted for sudden disturbance of consciousness;the second patient was admitted for recurrent attacks of hypoglycemia for more than 1 year,and reappearance of disturbance of conscious-ness for 1 h;the third patient was admitted for episodes of palpitation,sweating and limbs quiver for more than 1 year repeat-edly,and reappearance for 10 min. Immediate value of blood glucose was 0. 9-2. 0 mmol/L after admission,and the first diag-nosis in emergency department was hypoglycemia. The value of serum glucose of the first patient was still low after active treat-ment,and the insulinoma history was obtained from the family;the second patient had the insulinoma history by asking;value of serum glucose of the third patient returned to normal after carbohydrate supplement treatment,and insulinoma was confirmed after performing related examinations. The first one died of stubborn hypoglycemia and giving up treatment by family;the other 2 patients were turned to the superior hospitals for surgery. Conclusion Hypoglycemia is mainly cause inducing diabetes, but uncommon cause such as insulinoma can not be overlooked. Clinicians should not only supply active treatment,but also find the primary cause of hypoglycemia for patients with hypoglycemia in emergency department.%目的：探讨胰岛素瘤的临床特点和低血糖的病因鉴别诊断要点，以降低误诊率。方法对3例胰岛素瘤临床资料进行回顾性分析。结果本组例1以突发意识障碍入院；例2以反复发作性低血糖1年余，意识障碍再发1 h入院；例3以反复心悸、大汗、肢颤1年余，再发10 min入院。3例入院后即刻血糖0.9~2.0 mmol/L，急诊首诊低血糖症。例1经积极救治后，血糖仍持续偏低，家属到达后提供胰岛素瘤病史。例2追问病史获知胰岛素瘤病史。例3经补糖治疗后血糖恢复正常，完善相关检查后证实胰岛素瘤。例1因顽固性低血糖，家属放弃治疗后死亡；余2例转上级医院手术治疗。结论引起低血糖的常见原因是糖尿病，但少见病因如胰岛素瘤也不容忽视。对急诊低血糖患者要在积极救治的同时，注意查找导致低血糖的根本原因。
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