低钾型周期性麻痹诊断中运动诱发试验的应用分析

Correlation analysis of the exercise test and hypokalemic periodic paralysis

目的了解肌电图运动诱发试验与低钾型周期性麻痹发作期与缓解期的关系。方法收集被确诊为低钾型周期性麻痹患者45例（病例组）及健康体检者30例（对照组）。所有入选者均测定血清钾、肌酸激酶、甲状腺功能等相关生化指标。进行运动诱发试验（ET）测定并观察50min，复合肌肉动作电位波幅的降低率I〉33％即为ET阳性。分析ET在低钾型周期性麻痹诊断中的价值，及与相关生化检查的关系。结果病例组中ET阳性率明显高于健康对照组（80％vs3．3％，P〈0．01），并且在〉20min后波幅下降趋势明显，其波幅降低百分比在30min[（37．8±13．2）％VS（6．2±3．2）％，P〈0．01]、40min[（40．3±17．6）％VS（3．2±1．9）％，P〈0．01]、50min[（45．26±19．9）％V8（-5．1±2．6）％，P〈0．01]时与健康对照组比较差异均有统计学意义。病例组中血清钾与肌酸激酶水平呈负相关（r=-0．483，P=0．024）。病例组经过治疗一周后复查ET，其阳性发生率无明显变化（80．0％V871．1％，P=0．824）。结论运动诱发试验是低钾型周期性麻痹诊断中重要的客观依据之一，且不受治疗及受检时间的影响。

Objectve To explore the application of exercise test use in diagnosis of periodic paralysis. Methods Forty five cases of hypokalemic periodic paralysis were collected, and 40 health persons as control group. Both groups were measured serum potassium, serum creatase and thyroid function tests. All of them were taken exercise test （ET） and observe 50 minutes, measured before and after the test to seek the changes of compound muscle action potentials （CMAP） , and its decreased more than 33% were considered abnormal. The application of exercise test use was analyzed in diagnosis of periodic paralysis. Results In patients with periodic paralysis, the incidence of ET positive was higher than the control subjects （80% vs 3.3%, P 〈 0. 001 ）. This trend was significant after 20 minutes, such as 30 rain [ （ 37.8±13.2）% vs （6.2±3.2）%,P〈0.01],40min [（40.3±17.6）% vs （3.2±1.9）%,P〈0.01],50min [ （45.26±19. 9）% vs （ -5. 1±2. 6）% ,P 〈0. 01 ]. Moreover, linear correlation analysis showed that the serum potassium had negative correlation with serum ereatase （ r = -0. 483, P = 0. 024）. ALL of symptoms improved after a week treatment, the ET positive rate was still higher in patients with periodie paralysis than the control subjects （80. 0% vs 71.1% , P = 0. 824）. Conclusions Exercise test was one of the important objective basis in the diagnosis of low potassium type periodie paralysis, and was not affected by treatment and testing time.