运动诱发试验对周期性麻痹18例的诊断价值  

Value of exercise test in the diagnosis of 18 patients with periodic paralysis

作　　者：丁则昱[1] 刘明生[1] 崔丽英[1] 

机构地区：[1]中国医学科学院中国协和医科大学北京协和医院神经内科,100730

出　　处：《中华神经科杂志》2007年第4期242-245,共4页Chinese Journal of Neurology

摘　　要：目的探讨运动诱发试验对周期性麻痹的诊断价值。方法对试验组18例周期性麻痹患者及对照组20名健康人进行运动诱发试验测定。结果运动后,对照组波幅迅速增高(13.10%±5.27%),此后波幅逐渐同落井低于基线(20.90%±5.49%),在20 min 内开始回复。试验绀波幅迅速增高(20.56%±23.44%),随后逐渐减低(48.94%±22.20%)并持续不缓解。试验组波幅减低率显著大于对照绀(P=0.000);波幅增高率与对照组比较差异无统计学意义(P=0.174)。试验组的检查18例中14例异常,运动试验前18例中有6例确诊,运动试验后增加为15例。结论运动诱发试验是周期性麻痹很好的辅助诊断方法。Objective To evaluate the value of exercise test （ET） in the identification of patients with periodic paralysis. Methods Standardized protocols of long exercise tests were applied on 20 health control subjects and 18 patients with clinically definite or possible periodic paralysis. Results In control subjects, a long exercise test slightly increased compound muscle action potentials （CMAP） amplitude （13.10% ±5. 27% ） immediately after the completion of exercise. Subsequently, the values of the CMAP fell below the pre-exercise level （20.90% ±5.49% ）, but returned to the baseline value within 20 min. In patients with periodic paralysis, CMAP amplitude increased immediately after exercise （20. 56% ± 23.44% ）. Then, 10-20 minutes after the end of exercise, a significant and prolonged decrease of CMAP amplitude appeared （48.94% ± 22.20% ）. The decrease in patients was significantly larger than that in control subjects （P = 0. 000）, but the increase was not significantly larger than that in controls （P = 0. 174）. The ET was abnormal in 14 of the 18 patients we had studied. 15 patients were accurately diagnosed by ET, whereas only 6 patients were before this examination. Conclusion The exercise test, a technique indicating the excitability of muscle fibre membrane, helps diagnosis in asymptomatic periodic paralysis patients.

关 键 词：低钾性周期性麻痹 运动试验 

分 类 号：R746[医药卫生—神经病学与精神病学]