目的:甲状腺毒性周期性麻痹(TPP)的特征是肌肉麻痹和显着的细胞内钾运动导致低钾血症。由于TPP是一个罕见的条件,只有少数研究阐明了这种疾病患者的临床特征。这项研究旨在通过将TPP患者与无瘫痪(非TPP)和散发性周期性瘫痪(SPP)的甲状腺毒症患者进行比较,以阐明TPP患者的临床特征。
方法:这是一项单中心回顾性队列研究。从电子病历中提取并分析了我院急诊收治的甲状腺功能亢进(n=62)或周期性瘫痪(n=92)患者的临床资料。
结果:TPP组所有患者(男15例,女2例)均患有Graves病,14人是新诊断的。入院时平均血清钾水平为2.3±0.75mEq/L。血清钾水平之间没有观察到显著的相关性,正常化所需的钾含量,甲状腺激素水平.TPP组表现出明显的年轻化,较高的男性比例和体重指数(BMI),血清钾和磷水平低于非TPP组,其中包括36名Graves病患者。在年龄方面,TPP和SPP(n=11)组之间没有观察到显着差异,性别,BMI,血清电解质水平,正常化所需的钾,和恢复时间。
结论:考虑到大多数TPP患者患有未确诊的Graves病,在急诊情况下,仅根据临床信息和病程很难区分TPP和SPP.因此,早期发现和启动对Graves病的特异性治疗,在治疗周期性瘫痪患者时,需要筛查甲状腺激素和抗甲状腺刺激激素受体抗体水平.
OBJECTIVE: Thyrotoxic periodic paralysis (TPP) is characterized by muscle paralysis and significant intracellular potassium movement resulting in hypokalemia. Since TPP is a rare condition, only a few studies have explicated the clinical characteristics of patients with this disease. This
study aimed to elucidate the clinical characteristics of patients with TPP by comparing them with those with thyrotoxicosis without paralysis (non-TPP) and sporadic periodic paralysis (SPP).
METHODS: This was a single-center retrospective cohort
study. Clinical data of patients with hyperthyroidism (n = 62) or periodic paralysis (n = 92) who were emergently admitted to our hospital was extracted from the electronic medical records and analyzed.
RESULTS: All patients in the TPP group (15 males and 2 females) had Graves\' disease, with 14 being newly diagnosed. The average serum potassium level on admission was 2.3±0.75 mEq/L. No significant correlation was observed among serum potassium level, amount of potassium required for normalization, and thyroid hormone levels. The TPP group showed significantly younger age, higher male ratio and body mass index (BMI), and lower serum potassium and phosphorus levels than the non-TPP group, which comprised 36 patients with Graves\' disease. No significant differences were observed between the TPP and SPP (n = 11) groups in terms of age, sex, BMI, serum electrolyte levels, potassium requirement for normalization, and recovery time.
CONCLUSIONS: Considering that most patients with TPP have undiagnosed Graves\' disease, distinguishing TPP from SPP based on clinical information and course alone is difficult in emergency settings. Therefore, for early detection and launch of specific treatment of Graves\' disease, screening for thyroid hormone and anti-thyroid stimulating hormone receptor antibody levels is necessary when treating patients with periodic paralysis.