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中国人群中的甲状腺毒症性周期性瘫痪:45例临床特征

Thyrotoxic periodic paralysis in the Chinese population: clinical features in 45 cases.

作者信息

Li J, Yang X B, Zhao Y

机构信息

Emergency Center of Zhongnan Hospital, Wuhan University, China.

出版信息

Exp Clin Endocrinol Diabetes. 2010 Jan;118(1):22-6. doi: 10.1055/s-0028-1112150.

Abstract

OBJECTIVE

Thyrotoxic periodic paralysis (TPP) occurs predominantly in Asian males, but there are few reports about TPP in the mainland of the People's Republic of China. The purpose of this study was to report the clinical features of cases of TPP in mainland China.

METHODS

Forty-five cases of TPP, admitted to Zhongnan Hospital of Wuhan University during a 5-year period, were retrospectively reviewed.

RESULTS

Patients typically presented with acute paralysis of the limbs, almost half (48.6%) initiated with legs, while the rest (51.4%) with both arms and legs. Twenty of 45 patients (44.4%) who had been diagnosed with hyperthyroidism suffered sudden attacks, while the remaining 25 patients were newly diagnosed with TPP. 16 patients had low potassium serum concentrations (1.44-3.00 mmol/L). There was a correlation between the lowest muscle strengths of the proximal and distal legs and serum potassium concentrations (Spearman correlation, r=0.556, P=0.049).

CONCLUSIONS

TPP is not an uncommon disease in mainland China. Thyrotoxic patients need to improve medication compliance and follow-up. At the time of the TPP attack, a detailed interview and inquiry with a thorough physical examination usually provide clues to the diagnosis. Leg muscle strength evaluation may be useful to assess the severity of hypokalemia.

摘要

目的

甲状腺毒症性周期性瘫痪(TPP)主要发生在亚洲男性中,但关于中华人民共和国大陆地区TPP的报道较少。本研究的目的是报告中国大陆地区TPP病例的临床特征。

方法

回顾性分析武汉大学中南医院5年间收治的45例TPP患者的资料。

结果

患者通常表现为急性肢体瘫痪,近半数(48.6%)首发于腿部,其余(51.4%)首发于双臂和双腿。45例已诊断为甲状腺功能亢进的患者中有20例(44.4%)突发病情,其余25例为新诊断的TPP患者。16例患者血清钾浓度较低(1.44 - 3.00 mmol/L)。下肢近端和远端肌肉力量的最低值与血清钾浓度之间存在相关性(Spearman相关性,r = 0.556,P = 0.049)。

结论

TPP在中国大陆并非罕见疾病。甲状腺毒症患者需要提高用药依从性并加强随访。在TPP发作时,详细的问诊和全面的体格检查通常可为诊断提供线索。评估腿部肌肉力量可能有助于评估低钾血症的严重程度。

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