86例周期性瘫痪的临床分析  

Characteristics of Patients with Periodic Paralysis

作　　者：杨绍容[1] 周立[1] 

机构地区：[1]四川省内江市第一人民医院神经内科,四川内江641000

出　　处：《中国医药指南》2012年第30期25-26,共2页Guide of China Medicine

摘　　要：目的探讨周期性瘫痪(PP)的临床特点及辅助检查结果。方法对我院已经确诊的86例PP病例的临床资料进行回顾性分析。结果 86例PP患者中47例由多种诱因诱发,40例(46.5%)继发于甲亢。PP表现为肢体瘫痪,呈对称性,近端重于远端,从下肢发展到上肢。血清钾均降低,52例(60.5%)有肌酶学变化,以肌酸磷酸激酶(CPK)增高为主。周期性瘫痪治疗措施包括补钾,密切监测血钾,甲亢性低钾型周期瘫痪须合用抗甲状腺药物及β受体阻滞剂。结论 PP发作由多种诱因诱发,部分与甲状腺功能亢进症有关。多数有肌酶学变化,以CPK增高明显。心电图检查有助于确诊本病。Objective To investigate the clinical characteristics and laboratory profiles of patients with periodic paralysis（PP）.Methods Clinical and laboratory data of 86patients with periodic paralysis were retrospectively reviewed and analyzed.Results There were 40（47.3%）cases of thyrotoxic periodic paralysis（TPP）which were induced by hyperthyroidism.And47cases of PP were induced by multiple inducements.The major clinical symptoms of PP were symmetrical paralysis.Neurological symptoms were severer in proximal limbs than that in distal limbs.Weakness developed earlier in lower extremities than in upper extremities.Serum potassium concentrations were decreased in all episodes.The change of muscle enzyme were common in52（60.5%）cases of PP patients,which were mainly revealed the increasing of serum creatine phosphokinase.Acute management of PP consists of potassium chloride supplementation,careful observation,and close monitoring of serial potassium concentrations.Patients with PP and hyperthyroidism should be received antithyroid drugs combined with β-blockers therapy.Conclusions PP was induced by multiple inducements including hyperthyroidism.In most cases,the change of muscle enzyme occurred with mainly increase of serum CPK.Electrocardiogram is helpful in diagnosis of periodic paralysis.

关 键 词：周期性瘫痪 低血钾 血清肌酸磷酸激酶 甲状腺功能亢进 

分 类 号：R746.3[医药卫生—神经病学与精神病学]