摘要
目的 :分析Graves病 (GD甲亢 )患者低血钾倾向 (血钾≤3.7mmol/L)的临床特点和发病机制。方法 :对378例GD甲亢患者进行分析。结果 :(1)无突眼无甲状腺肿 (甲肿 )的患者低血钾倾向大于有突眼和(或)甲肿的患者 (P<0.01)。(2)无周期性麻痹的GD甲亢患者中 ,女性低血钾倾向性显著大于男性 (P<0.01)。(3)GD甲亢男性患者血钾与24h尿钾无直线相关关系 ,而女性低血钾倾向患者补钾后血钾与24h尿钾呈直线负相关 (P<0.01)。(4)GD甲亢患者低血钾倾向与血FT3、FT4 水平和24h尿钙无关。结论 :突眼和甲肿体征均不明显的患者更易发生低血钾倾向。关于低血钾的发病机制 ,男性可能和肾外因素 ,如甲亢周期性麻痹有关 ,单一的血清甲状腺激素升高并不能解释其低血钾的原因 ;而女性则可能与肾小管受损。
Objective:To analyze the clinical features and pathogenic mechanisms of hypokalemic tendency in Graves disease(GD).Methods:To retrospectively analyze378patients with GD.Results:(1)The hypokalemic tendency in GD patients without exophthalmos and goiter seemd to be much more frequently than that in GD patients with exophthalmos and(or)goiter(P<0.01).(2)In GD patients without thyrotoxic periodic paralysis,hypokalemic tendency was more obvious in female group than that in male group(P<0.01).(3)In GD male group,serum potassium had no linear correlation with24-hour uric potassium.In GD females with hyˉpokalemic tendency,serum potassium had a significant negative linear correlation with24-hour uric potassium after potassium chloride was taken(P<0.01).(4)In GD males and females,hypokalemic tendency was not related to serum FT 3 and FT 4 levels,and24-hour uric calcium.Conclusion:(1)GD patients without exophˉthalmos and goiter showed a significant hypokalemic tendency than those with exophthalmos and(or)goiter.(2)The pathogenic mechanisms of hypokalemia are probably different between males and females with Graves disˉease.In GD males,the hypokalemia is probably due to extrarenal factors such as the damages to the musculaˉture in thyrotoxic periodic paralysis,and has no correlation to the elevation of serum thyroid hormones.In GD females,the hypokalemia is probably caused by the damages to renal tubule,leading to potassium lose from kidney.
出处
《天津医药》
CAS
北大核心
2004年第7期403-405,共3页
Tianjin Medical Journal
