摘要
目的 探讨毒性弥漫性甲状腺肿 (Graves病 )患者胰岛素 (Ins)水平与低钾周期性麻痹的关系。 方法 选择 1998～ 2 0 0 1年在我院门诊和住院的 2 32例Graves病患者 ,均予检测血钾、糖化血红蛋白和口服葡萄糖耐量试验 (OGTT)、血浆Ins、C肽释放试验 ,并与 4 3名健康成人比较。 结果 (1)甲状腺功能亢进症 (甲亢 )伴低钾周期性麻痹的患者全部为男性。 (2 )甲亢患者有葡萄糖耐量受损和高胰岛素血症 ,表现为OGTT中 2h血糖不能达到正常水平 ,有低钾周期性麻痹患者最为明显 ,为 (10± 3)mmol/L。甲亢伴低钾周期性麻痹患者胰岛素和C肽释放分别为 (中位数 ) :18 0 5、6 7 80、95 5 0、119 0 0、75 0 0mU/L和 2 97、6 0 0、7 6 0、11 80、6 90 μg/L ,明显高于健康成人和无低钾周期性麻痹的甲亢患者 ,差异有显著意义。 结论 甲亢伴低钾周期性麻痹患者存在高胰岛素血症和葡萄糖耐量异常 ,血清钾下降与血浆胰岛素增高、血钾向细胞内转移有关。预防和治疗高胰岛素血症也是预防和治疗甲亢伴低钾周期性麻痹的又一措施。
Objective To investigate relationship between serum insulin level and hypokalemic myoparalgsis in Graves' hyperthyroidism Methods We investigated 232 in patients with hyperthyroidism from 1998 to 2001 HbA 1c, OGTT, and serum insulin and C peptide levels were analyzed Results At 0,30,60,120,180 muinutes after OGTT blood glucose levels were 4 59,7 87,8 00,5 93,4 50 (mmol/L) respectively in normal control, but were 5 07,8 89,10 50,10 10,5 83 (mmol/L) respectiwely in hypokalemic periodic paralysis in hyperthyroidism At 0,30,60,120,180 minutes after OGTT, insulin and c peptide levels were10 10,40 00,55 40,53 30,31 40 (mU/L) and 1 88,4 00,6 18,6 41,5 14(μg/L) respectively in normal contol but were 18 05,67 80,95 50,119 00,75 00(mU/L) and 2 97,6 00,7 60,11 80,6 90 (μg/L) respectively in hypokalemic periodic paralysis Conclusion The hyperthyroidism patients have hyperinsulinemia and impaired glucose tolerance, which may be associated with hypokalemic paralysis.
