西藏地区低钾型周期性瘫痪15例患者临床分析

Clinical analysis of 15 cases with hypokalemic periodic paralysis in Tibet

目的探讨西藏地区低钾型周期性瘫痪(HPP)患者的发病原因、临床特征、治疗效果,提出西藏地区HPP临床特点。方法分析拉萨市人民医院入院收治的15例HPP患者的临床资料。结果 15例HPP患者均为散发性,男性13例,女性2例,2例合并发生甲亢,2例原发性高血压,明确诱因者仅5例,其他患者除饮食结构简单外无明显诱因。四肢瘫痪对称者9例,不对称者6例,所有患者经补钾治疗后临床症状显著改善。结论西藏地区HPP低钾比较严重,1/3(5/15)患者诱因与饮酒、感冒、腹泻等相关外,其他患者主要与饮食结构简单可能相关;四肢不对称性软瘫是周期性瘫痪的常见类型,心电图(ECG)改变不典型;补钾治疗效果明显,且肌力好转早于血清钾水平改善。

Objective To discuss the etiology,clinical feathers and treatment effects of hypokalemic periodic paralysis（HPP） cases aimed to improve diagnostic and therapic ability in tibet. MethodRetrospective analysis on clinical manifestations, treatments and affects were hold on 15 inpatients with HPP in our hospital.Results All 15 HPP cases were sporadic, 13 cases male and 2 cases female. Respectively there were 2 cases complicating hyperthyrosis and primary hypertension. There were only 5 cases with exact inducing factor, and others patients had no exact inducing factor except for simple dietary structure. There were 9 cases with symmetrical palsy and 6 cases with asymmetrical palsy. All cases had improved significantly after potassium supplement therapy.Conclusion Hypokalemia with HPP cases in tibet was serio us. Inducing factors of 1/3（5/15）patients with HPP in tibet was associated with alcohol, influenza and diarrhoea but others mainly with simple dietary structure. Asymmetrical palsy was the most typical manifestation and electrocardiography（ECG） was untypically in HPP patients in tibet.Potassium supplement therapy had a effective clinical results but improvement of muscle power was earlier than which of serum potassium.