运动诱发试验在低钾型周期性麻痹诊治中的应用  

A study of exercise test in patients with hypokalemic periodic paralysis

作　　者：刘海玲[1] 苏曼[1] 童晓欣[1] 

机构地区：[1]北京大学深圳医院神经内科,深圳518036

出　　处：《癫痫与神经电生理学杂志》2011年第3期152-155,共4页Journal of Epileptology and Electroneurophysiology(China)

摘　　要：目的：探讨运动诱发试验（exercisetest，ET）在低钾型周期性麻痹中的诊断价值及相关影响因素。方法：对我院门诊确诊低钾型周期性麻痹的30例患者，在发作期检查肌力、血清钾（K^＋）、肌酸激酶（CK）、甲状腺功能，发作间期复查肌力、K^＋、CK值，并进行ET测定。同时选择30例健康人作为对照组。结果：发作期K^＋值的高低与肌力改变呈正相关，与CK值的高低呈负相关。发作间期行ET，30例患者波幅逐渐下降（45．56％±19．91％），其波幅减低百分比显著大于对照组（P=0．001）。ET波幅变化百分比与肌力、K^＋、CK水平无明显相关性。结论：ET可作为低钾型周期性麻痹发作间期的重要辅诊方法。ET阳性与发病机制有关，与起病形式、严重程度无相关性。Objective：To explore the effect of exercise test （ET） in identifying patients with hy pokalemic periodic paralysis（HOPP） and the related factors that could affect the responses. Methods： Thirty patients with HOPP were enrolled healthy volunteers served as controls. Muscle power, serum potassium（K＋ ）, serum creatase and thyroxine were examined during the stage of attack. ET were applied during interphase. Results：Compared with the controls, there was a significantly positive correlation between serum K＋ and muscle power and negative correlation between serum K ＋ and serum creatase in the attack period. ET indicated a significant decrease of CMAP amplitude （45.56% ± 19.91%）. The decrease in the patients was significantly larger than that in control subjects（P=0. 001）. There were no obvious relevance between change of CMAP amplitude and serum K＋ ,serum creatase, or muscle power. Conclusion： ET can be used as a confirmative test for the diagnosis of the periodic paralysis during asymptomatic period. ET result is related to the mechanism, while there appears to be no correlation with mode of onset and severity of hypokalemic periodic paralysis.

关 键 词：低钾型周期性麻痹 运动诱发试验(ET) 血清钾 肌酸激酶 肌力 

分 类 号：R746.3[医药卫生—神经病学与精神病学] R741.044[医药卫生—临床医学]