TTKG在低钾型周期性瘫痪诊断和治疗中的意义  

The effects of the transtubular potassium concentration gradient on the diagnosis and treatment for hypokalemic periodic paralysis

作　　者：黄晓芸[1] 梅志忠[1] 罗进才[1] 曾进胜[2] 

机构地区：[1]广东省东莞市厚街医院神经内科,东莞523945 [2]中山大学附属第一医院神经内科

出　　处：《中国神经精神疾病杂志》2008年第6期342-344,共3页Chinese Journal of Nervous and Mental Diseases

摘　　要：目的探讨经肾小管尿钾浓度梯度(transtubular potassium concentration gradient,TTKG)测定在低钾型周期性瘫痪(hypokalemic periodic paralysis,HPP)诊断和治疗中的意义。方法前瞻性选择低钾型周期性瘫痪患者64例,根据病因分为原发组、继发组和甲亢组,健康志愿者25名作为对照组。测定血/尿钾浓度和渗透压,根据其结果计算TTKG,比较其组间TTKG的差异;按TTKG分组,比较组间补钾总量和症状恢复时间的差异,统计补钾治疗后出现反跳性高血钾的情况。结果原发组TTKG为(1.74±0.44),继发组为(4.59±1.05),甲亢组为(1.74±0.55),正常对照组为(7.21±1.38),比较有统计学意义(P<0.01);原发性HPP患者应少补钾,相反,继发性HPP应多补钾。结论TTKG可在早期作为鉴别原发性与继发性HPP的指标之一,并指导治疗,避免补钾治疗后出现反跳性高钾血症。Objective To observe the effects of transtubular potassium （ K^＋ ） concentration gradient （TTKG） on the diagnosis and treatment for hypokalemic periodic paralysis （HPP）. Methods Sixth - four severe HPP patients with profound weakness were selected and further divided into three groups according to its pathogeny （primary, secondary and thyrotoxic hypokalemic periodic paralysis） and 25 young healthy volunteers served as matched controls. Results TTKG in patients with primary as well as secondary hypokalaemic periodic paralysis, thyrotoxic hypokalaemic periodic paralysis and controls were （ 1.74 ±0. 44） , （4. 59 ± 1.05） , （ 1.74 ±0. 55） , and （7. 21 ± 1.38） , respectively. The amount of potassium supplements and the time of functional recovery were significantly different between patients with and without monitoring of TTKG （ P 〈 0. 01 ）. Conclusions TTKG may be helpful for diagnosis and treatment of hypokalemic periodic paralysis.

关 键 词：经肾小管尿钾浓度梯度 低钾型周期性瘫痪 诊断与治疗 

分 类 号：R746.3[医药卫生—神经病学与精神病学]