甲亢性周期性瘫痪心电图、心肌酶变化及临床特点分析

Clinical characteristics,ECG and cardiac enzymes changes in patients with thyrotoxic periodic paralysis

目的分析甲亢性周期性瘫痪患者心电图、心肌酶变化及临床特点。方法回顾性分析1997年1月~2009年5月间甲亢合并周期性瘫痪（TPP）患者31例,分析其临床发病特点及心电图、心肌酶在发病前后的变化特点。结果 TPP心电图异常18例,其中窦性心动过缓占35.2%,表现为T波低平,ST段下降,P-R间期延长,可见U波。窦性心动过速占12.9%,2例出现传导阻滞。发病时血清钾均低于正常。7例出现心肌酶升高。结论及时发现心电图变化,及早补钾纠正心律失常,早期积极治疗甲亢是治疗TPP的关键。

Objective To analyze the clinical characteristics,ECG and cardiac enzymes changes in patients with thyrotoxic periodic paralysis.Methods Retrospective review was performed on 31 patients with hyperthyroidism with periodic paralysis（TPP）,clinical characteristics of TPP and ECG,myocardial enzymes changes before and after the changes of the disease.Results 18 cases abnormal ECG in TPP,including 35.2% sinus tachycardia,with T wave horizon,S-T segment depression,P-R interval prolongation and u wave.12.9% sinus bradycardia,2 cases conduction block.Incidence of serum potassium was lower than normal.Enzyme increased in 7 cases.Conclusions Finding ECG changes timely,applying potassium earlier to correct arrhythmias,and aggressive treatment of hyperthyroidism were the keys in TPP treatment.