低钾周期性麻痹并发白细胞计数增高原因探讨

Analysis of the Etiology of Periodic Paralysis with Hypokalemia Accompanied by High Level of WBC Count

目的对几近100%低钾周期性麻痹患者合并外周血白细胞计数增高的原因进行研究,同时对此病的病因及合理的治疗方法一并作粗略探讨。方法对160例低钾周期性麻痹患者随机分为例数相同的4组后分别采用不同的方法治疗,连续监测各组病人血钾浓度、外周血白细胞计数、血浆皮质醇浓度,研究各项指标变化的关联性。结果是否使用抗生素并不改变白细胞计数的变化趋势;随着病人血浆皮质醇浓度下降至正常范围,血钾浓度及外周白细胞计数也缓慢而平稳地恢复至正常范围。结论感染并非外周血白细胞升高的主要原因,低血钾与高血像可能均系应激反应的结果,为小剂量缓慢补钾的合理性找到又一证据;尽快地消除应激因素可能是比补充钾盐更为重要的举措。

Objective To study the etiology of the high level of WBC count discovered in almost 100 percent of patients with periodic paralysis caused by hypokalemia,and the appriatiate therapy of hypokalemia were assumably discussed. Methods 160 patients with hypokalemia were randomly divided equally into four groups and the therapy of each group was different each other. The levels of blood kalium, WBC count and serum cortisol of each patient were continuously detected. The pertinence of the changes of these targeted values was analysed. Results The tendency of change of WBC count was irvespective of whether the antibacterial drug was used. While the level of serum cortisol descended into normal range,the levels of blood kalium and WBC count returned to normal slowly. Conclusion The high level of WBC count was not caused primarily by infection,the abnormal levels of blood kalium and WBC count were probably caased by the stress. It was reasonably to slowly supply patassium chloride for the patient with hypokalemia. To remose the stress from a patient as soon as possible might be more imnortant than to supply notassiam chloride.