^(131)I治疗甲亢合并周期性瘫痪

Treatment of Hyperthyroidism Complicated with Periodic Paralysis by ^(131)I

目的:探讨甲亢合并周期性瘫痪的临床特点、诊治要点及放射性碘(^(131)I)的疗效。方法:回顾性分析2012年6月至2015年6月就诊我院的甲亢合并周期性瘫痪病例41例(TPP组)与甲亢不合并周期性瘫痪病例55例(NTPP组)的临床资料和^(131)I治疗后结局。结果:TPP组男性占92.68%(38/41),NTPP组男性占25.45%(14/55),二者差异有统计学意义(P<0.05);TPP组的甲状腺估重和眼球突出度与NTPP组比较,差异有统计学意义(P<0.05);^(131)I治疗后早发甲减例数(12/41,29.27%)与NTPP组(9/55,16.36%)比较,差异有统计学意义(P<0.05)。结论:突发周期性瘫痪年轻男性患者就诊时应考虑到可能是甲亢所致,在积极补钾的基础上应尽快控制甲亢,建议将^(131)I作为首选治疗方法。

Objective To explore the clinical characteristics, diagnosis and outcomes of radioactive iodine （^131I） therapy in patients with hyperthyroidism complicated with periodic paralysis. Methods From June 2012 to June 2015, the clinical data and outcomes of ^131I therapy in 41 patients of hyperthyroidism complicated with periodic paralysis （group TPP） and 55 patients of hyperthyroidism without periodic paralysis （group NTPP） were retrospectively analyzed in our hospital. Results The male patients was respectively accounted for 92.68% （ 38/41 ） and 25.45%（14/55） in group TPP and group NTPP, there was significant difference in the two group（P〈O.05）. The estimated weight of thyroid gland and degree of exophthalmus in patients were significant differences between two groups （P〈0.05）. The incidences of early hypothyroidism were respectively 29.27% （12/41） in group TPP and 16.36% （9/55） in group NTPP, and the difference between the two groups were statistically difference（ P〈0.05）. Conclusion Hyperthyroidism should be considered wbenperiodic paralysis suddenly occured in the young male, the therapy principle is given to maintain blood potassium and control the symptom of hyperthyroidism as soon as possible, t3~I is recommended as the first therapy choice.