文档介绍：甲亢性周期性瘫痪30例临床分析

【摘要】目的探讨以低钾性瘫痪为主要临床表现的甲状腺功能亢进症(甲亢)的发病相关因素及治疗方法。方法对30例甲亢性周期性瘫痪(TPP)的临床资料进行回顾性分析。结果发作时均有不同程度双下肢或四肢瘫痪;T3、T4均高于正常。结论甲亢性周期性瘫痪以年轻男性多见,补钾短期内可改善TPP症状,抗甲亢治疗是预防TPP复发的关键。
【关键词】甲状腺功能亢进; 周期性瘫痪
【Abstract】 Objective To investigate the pathogenic related factor of hyperthyroidism with clinical manifestation of low potassium paralysis and its regimen. Methods The clinical data of 30 patients with thyrotoxic periodic paralysis (TPP) were analysed. Results All 30 patients had different paralysis of bilateral lower limbs or four limbs in the onset of TPP and panied with the blood K+ values of T3 and T4 in all patients were higher than those in normal people. Conclusion The male patients with thyrotoxic periodic paralysis are more than female patients. Replenishing K+ can shortly ameliorate the symptom of thyrotoxic periodic paralysis,and the antihyperthyroidism therapy is key to control the recurrence of thyrotoxic periodic paralysis.
【Key words】 Hyperthyroidism; Periodic paralysis
甲亢性周期性瘫痪(thyrotoxic periodic paralysis, TPP)是甲状腺功能亢进症(甲亢)常见的神经肌肉疾病,以反复发作的肌体骨骼肌无力伴低血钾为主要临床特征。1998年1月~2006年5月我院收治TPP患者30例,现总结报告如下。
1 资料与方法
一般资料本组30例,男26例、女4例,初发28例、复发2例,年龄18~45岁、中位年龄26岁。发作至就诊时间: h~1 d,少数为1~2 d。确诊为Graves病28例,毒性甲状腺瘤2例,无长期服用甘油制剂和利尿剂史,均排除家族性周期性瘫痪、散发性周期性瘫痪、原发性醛固酮增多症、肾小管酸中毒、Bartter综合征、Gitelman综合征等疾病。
临床表现①起病急,四肢无力呈进行性加重,以双下肢为重。8例为肢体对称性软瘫,肌力0~4级,腱反射减