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[正常血钾型周期性瘫痪患者氯化钾诱发麻痹发作时心脏功能的评估]

[Evaluation of cardiac function during KCl-induced paralytic attack in the patients with normokalemic periodic paralysis].

作者信息

Sebe T, Kawai H, Kubo K, Mizobuchi M, Saito S

机构信息

First Department of Internal Medicine, School of Medicine, University of Tokushima.

出版信息

Rinsho Shinkeigaku. 1991 Jan;31(1):19-23.

PMID:2044301
Abstract

Some reports have been written about hypokalemic periodic paralysis dealing with cardiac dysfunction and arrhythmia during the paralytic attack. However, no reports have been written about the cardiac function during the attack in cases of normokalemic periodic paralysis. So, we investigated cardiac function in two patients with normokalemic periodic paralysis. A 3.0 g dose of KCl was administered orally to the patients (1 male, 1 female) and 10 healthy volunteers (5 males, 5 females). Cardiac function by using ejection time (ET)/pre-ejection period (PEP), grasping power, and the level of plasma catecholamine were measured during the paralytic attack. Changes in the patients were compared with those in the volunteers. Next, a 3.0 g dose of KCl was administered to the patient, followed by intravenous dosing of 10% NaCl (50 ml) after which ET/PEP and grasping power measured. Lastly, a 60 mg dose of diltiazem, a 10 mg dose of nifedipine or a 80 mg dose of verapamil were administered, followed by a 3.0 g dose of KCl after which ET/PEP and grasping power were measured again. Thirty minutes after the administration of KCl, the grasping power decreased remarkably, from 32.0 kg to 17.0 kg in the male patient and from 30.0 kg to 20.0 kg in the female patient. By contrast, the ET/PEP showed a clear increase, from 3.47 to 6.17 in the male patient and from 2.84 to 5.45 in the female patient. Grasping power of the volunteers, however, did not change remarkably (avg. 40.3 kg before vs. 40.9 kg after in the males and avg. 26.9 kg before vs. 26.0 kg after in the females) and ET/PEP of the volunteers did not change remarkably (avg. 3.37 before vs. 3.17 after in the males and avg. 3.30 before vs. 3.43 after in the females). No significant changes were found in the levels of plasma catecholamine during the paralytic attack.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

一些关于低钾性周期性麻痹的报告涉及到麻痹发作期间的心脏功能障碍和心律失常。然而,关于正常血钾性周期性麻痹发作期间心脏功能的报告尚未见报道。因此,我们对两名正常血钾性周期性麻痹患者的心脏功能进行了研究。给患者(1名男性,1名女性)和10名健康志愿者(5名男性,5名女性)口服3.0克氯化钾。在麻痹发作期间,通过使用射血时间(ET)/射血前期(PEP)、握力和血浆儿茶酚胺水平来测量心脏功能。将患者的变化与志愿者的变化进行比较。接下来,给患者服用3.0克氯化钾,然后静脉注射10%氯化钠(50毫升),之后测量ET/PEP和握力。最后,给予60毫克地尔硫䓬、10毫克硝苯地平或80毫克维拉帕米,随后给予3.0克氯化钾,之后再次测量ET/PEP和握力。服用氯化钾30分钟后,握力显著下降,男性患者从32.0千克降至17.0千克,女性患者从30.0千克降至20.0千克。相比之下,ET/PEP明显增加,男性患者从3.47增至6.17,女性患者从2.84增至5.45。然而,志愿者的握力没有明显变化(男性平均发作前40.3千克,发作后40.9千克;女性平均发作前26.9千克,发作后26.0千克),志愿者的ET/PEP也没有明显变化(男性平均发作前3.37,发作后3.17;女性平均发作前3.30,发作后3.43)。在麻痹发作期间,血浆儿茶酚胺水平未发现显著变化。(摘要截选至250字)

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