低钾性周期性麻痹与高胰岛素血症的相关性及干预性治疗的临床研究

Clinical Study of Hypokalemic Periodic Paralysis's Intervention Therapy and Its Correlation with Hyperinsulinemia

目的探讨低钾性周期性麻痹与高胰岛素血症的相关性以及干预性治疗的效果。方法选取2011年1月至2015年11月我院收治的低钾性周期性麻痹患者80例为观察组,同期健康体检人员50例为对照组。均行OGTT检测,比较两组的血糖、胰岛素水平,以及血清钾浓度和胰岛素曲线下面积,分析血清钾浓度与胰岛素的相关性。再选取合并高胰岛素血症患者60例,随机均分成两组,A组予以补钾对症治疗,B组除常规补钾外给予高胰岛素干预治疗,比较两组治疗后的血清钾浓度。结果观察组各个时间点的血糖、胰岛素水平均显著高于对照组,血清钾浓度显著低于对照组,差异有统计学意义(P<0.05);观察组胰岛素曲线下面积显著高于对照组,差异有统计学意义(P<0.05)。胰岛素与血清钾浓度存在负相关(r=-0.851,P=0.000)。经过不同治疗后,B组的血清钾浓度显著高于A组,差异有统计学意义(P<0.05)。结论高胰岛素血症与血清钾浓度存在负相关,高胰岛素血症会降低血钾浓度,从而加重低钾性周期性麻痹的病情,通过临床干预高胰岛素血症可以快速提高血清钾浓度。

Objective To explore the correlation between hypokalemic periodic paralysis and hyperinsulinemia, and the effect ofintervention therapy. Methods 80 cases of patients with hypokalemic periodic paralysis admitted to our hospital from January 2011 to November 2015 were selected as the observation group, and 50 cases of healthy controls were selected as the control group; Both groups received OGTT test, the blood glucose level, insulin level, serum potassium concentration and insulin curve area were compared betweenthe two groups, and the correlation between serum potassium concentration and insulin was analyzed. 60 cases of patients complicated with hyperinsulinemia in the observation group were randomly divided into two groups equally; The group A was treated with potassium supplement for symptomatic treatment, and the group B was treated with hyperinsulinemia intervention therapy on the basis of potassium supplement; The serum potassium concentration after treatment was compared between the two groups. Results The levels of blood glucose and insulin at different time points of the observation group were all significantly higher than those of the control group, and the potassium concentrations at different time points were all significantly lower than those of the control group （P 〈0.05）. The insulin curve area of the observation group was significantly higher than that ofthe control group （P 〈0.05）. Insulin and serum potassium concentration showed negative correlation （r = -0.851, P = 0.000）. After different treatments, the serum potassium concentration of patients in group B was significantly higher than that of patients in group A （P 〈0.05）. Conclusions Hyperinsulinemia has negative correlation with serum potassium concentration, and hyperinsulinemia would lower the serum potassium concentration, so as to aggravate the condition of hypokalemic periodic paralysis. Clinical intervention for hyperinsulinemia can quickly improve the serum potassium concentration.