甲状腺功能亢进症周期性麻痹死亡病例报告及文献分析

doi:10.3969/j.issn.1673-8640.2019.06.023

摘要/Abstract

摘要： 目前，我国甲状腺功能亢进症（简称甲亢）的发病率高达1.3%。甲亢患者死亡的原因多数是在手术中发生甲状腺危象。甲亢性周期性麻痹（hyperthyroidism and periodic paralysis，TPP）是甲亢的并发症之一，主要临床表现是甲状腺功能亢进、低钾血症、肌无力，患者可因呼吸衰竭而死亡。另外，持续的低钾血症还可引起心律失常[1] 。该病好发于男性，我国及日本、越南、菲律宾、韩国较为多见[2-3]。我国TPP患者占男性甲亢患者的13%，好发年龄为30～55岁[2，4]。有研究结果显示，TPP是环境因素、甲状腺毒症、基因易感性共同作用的结果[5]。本研究拟通过对1例TPP死亡病例的讨论并结合国内外文献进行的分析，探讨患者的死亡原因及TPP的发病机制，提高对TPP患者的临床治疗和管理水平，以降低发病率、死亡率，提高预后的转归。

中图分类号:

R446.1

郎昆, 马峻峰, 王玉明. 甲状腺功能亢进症周期性麻痹死亡病例报告及文献分析[J]. 检验医学, 2019, 34(6): 573-576.

. [J]. Laboratory Medicine, 2019, 34(6): 573-576.

图/表 1

参考文献 25

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组别	例数	rs623011（A/G）			等位基因（A/G）频率	rs312691（C/T）			等位基因（C/T）频率
组别	例数	AA	AG	GG	等位基因（A/G）频率	CC	CT	TT	等位基因（C/T）频率
中国江西、贵州、陕西地区^[23]	229
TPP组	127	78	40	9	0.772	82	39	6	0.799
甲亢对照组	102	12	70	20	0.461	15	66	21	0.471
中国四川地区^[27]	333
健康对照组	94	34	39	21	0.431	27	33	34	0.463
甲亢组	127	48	60	19	0.386	20	63	44	0.406
TPP组	112	15	43	54	0.674	56	39	17	0.674
中国台湾地区^[26]	190
TPP组	90	6	35	49	0.739
健康对照组	100	26	41	33	0.535
中国香港地区^[23]	204
TPP组	122								0.760
健康对照组	82								0.450
组别	例数	rs623011（A/G）			等位基因（A/G）频率	rs312691（C/T）			等位基因（C/T）频率
组别	例数	AA	AG	GG	等位基因（A/G）频率	CC	CT	TT	等位基因（C/T）频率
韩国^[25]	83
TPP组	43					22	14	7	0.674
甲亢对照组	40					2	27	11	0.388
泰国^[24]	223
TPP组	103	62	35	6	0.772
甲亢对照组	120	26	56	38	0.450

组别	例数	rs623011（A/G）			等位基因（A/G）频率	rs312691（C/T）			等位基因（C/T）频率
组别	例数	AA	AG	GG	等位基因（A/G）频率	CC	CT	TT	等位基因（C/T）频率
中国江西、贵州、陕西地区^[23]	229
TPP组	127	78	40	9	0.772	82	39	6	0.799
甲亢对照组	102	12	70	20	0.461	15	66	21	0.471
中国四川地区^[27]	333
健康对照组	94	34	39	21	0.431	27	33	34	0.463
甲亢组	127	48	60	19	0.386	20	63	44	0.406
TPP组	112	15	43	54	0.674	56	39	17	0.674
中国台湾地区^[26]	190
TPP组	90	6	35	49	0.739
健康对照组	100	26	41	33	0.535
中国香港地区^[23]	204
TPP组	122								0.760
健康对照组	82								0.450
组别	例数	rs623011（A/G）			等位基因（A/G）频率	rs312691（C/T）			等位基因（C/T）频率
组别	例数	AA	AG	GG	等位基因（A/G）频率	CC	CT	TT	等位基因（C/T）频率
韩国^[25]	83
TPP组	43					22	14	7	0.674
甲亢对照组	40					2	27	11	0.388
泰国^[24]	223
TPP组	103	62	35	6	0.772
甲亢对照组	120	26	56	38	0.450