Muscle membrane excitability after exercise in thyrotoxic periodic paralysis and thyrotoxicosis without periodic paralysis
Muscle membrane excitability after exercise in thyrotoxic periodic paralysis and thyrotoxicosis without periodic paralysis
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DOI：
10.1002/mus.20865
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发表时间：
2007-12-01
期刊：
影响因子：
3.4
通讯作者：
Higuchi, Itsuro
中科院分区：
文献类型：
--
作者：
Arimura, Kimiyoshi;Arimura, Ylimiko;Higuchi, Itsuro
我们评估了甲状腺功能亢进性周期性麻痹(TPP)的麻痹发作主要是由于先前存在的潜在异常引起的肌膜兴奋性异常，还是由于甲状腺激素的影响。采用延长运动试验(PE)对21例甲亢患者和11例甲亢无麻痹发作(Tw/OPP)患者的肌膜兴奋性进行了检测。比较了5例TPP患者和3例Tw/OPP患者的甲状腺功能亢进和正常状态的PE。与20名健康受试者相比，TPP患者的复合肌肉动作电位(CMAP)波幅在运动后即刻显著增加，而CMAP波幅从运动后20min开始呈时间依赖性逐渐下降。Tw/OPP患者的CMAP波幅也有明显下降，但仅在运动后50min。所有TPP和Tw/OPP患者的甲状腺功能状态都有改善的趋势；PE试验仅在TPP患者中异常。TPP患者的瘫痪发作主要是由于肌膜潜在的异常兴奋性，可能源于遗传。
We evaluated whether the paralytic attacks in thyrotoxic periodic paralysis (TPP) are primarily due to the abnormal excitability of the muscle membrane caused by a preexisting latent abnormality or to the effects of thyroid hormone. The prolonged exercise (PE) test was used to evaluate muscle membrane excitability in 21 patients with TPP and 11 patients with thyrotoxicosis without paralytic attacks (Tw/oPP) in the hyperthyroid state. The PE tests were compared between the hyperthyroid and euthyroid states in five of the TPP and three of the Tw/oPP patients. Compared to 20 healthy subjects, a significant increase in compound muscle action potential (CMAP) amplitudes immediately after exercise and a significant time-dependent gradual decline in CMAP amplitudes starting from 20 min after exercise were observed in the TPP patients. A significant decline in CMAP amplitudes was also observed in the Tw/oPP patients but only at 50 min after exercise. All of the TPP and Tw/oPP patients had a tendency to improve in the euthyroid state; the PE tests remained abnormal only in the TPP patients. Paralytic attacks in TPP patients are due primarily to a preexisting latent abnormal excitability of the muscle membrane, possibly genetic in origin.