甲亢伴与不伴低钾周期性麻痹患者血管紧张素和醛固酮水平的变化

目的 观察甲亢未合并低钾周期性麻痹（NTHPP）与甲亢低钾周期性麻痹（THPP）患者血浆血管紧张素I（ATI），血管紧张素Ⅱ（ATⅡ）及血清醛固酮（Ald）水平的变化，以探讨THPP与ATⅠ、ATⅡ、Ald之间关系。方法 对73例Graves病甲亢患者进行了血清钾、24小时尿钾、总三碘甲状腺原氨酸（TT3）、游离三碘甲腺原氨酸（FT3）、总甲状腺素（TT4）、游离甲状腺素（FT4）以及卧、立位ATⅠ、ATⅡ、Ald水平检测，其中THPP患者43例，NTHPP患者30例。结果 THPP组患者血清钾明显低于NTHPPP组患者（P＝0．000），24小时尿钾明显高于NTHPP组（P＝0．000）；THPP组患者立位ATⅡ、Ald水平明显高于NTHPP组（P分为0．008，0．013），THPP组卧位ATⅠ、ATⅡ、Ald及立位AT I较NTHPP组有升高趋势，但差异无显著性（P＞0．05）；24小时尿钾、立位ATⅡ、Al水平与血清钾水平呈负相关关系，立位Ald水平与24小时钾水平呈正相关关系。结论 THPP患者AT、Ald水平升高可能是THPP发病的病因之一，但其升高的原因尚有待进一步研究。

The levels of angiotensin and aldosterone in gases of hyperthyroid Graves' disease with and without hypokalemic periodic paralysis]

OBJECTIVE: To investigate the relationships between the changes of plasma angiotensin I (AT I). Angiotensin II (AT II). serum aldosterone (Ald) levels and hypokalemic periodic paralysis (THPP) complicating hyperthyroid Graves' disease. METHODS: The levels of serum potassium, TT3, TT4, FT3, FT4, Ald and the plasma AT I, AT II and 24 hours urine potassium output were determined in 73 cases of hyperthroid Graves' disease, of which 43 were complicated by THPP and the other 30 were grouped as NTHPP cases. RESULTS: The mean level of serum potassium in THPP group was significantly lower than that in NTHPP group (P = 0.000), and the mean level of 24 hours urine potassium output in THPP group was significantly higher than that in NTHPP group(P = 0.000); The mean levels of plasma AT II and serum Ald in THPP group in upright position were significantly higher than those in NTHPP group (P = 0.008 and 0.013, respectively). The mean levels of 24 hours urine potassium output, plasma AT II and serum Ald in upright position were negatively correlated to serum potassium in both groups. The level of serum Ald in upright position was positively correlated to the level of 24 hours urine potassium out-put. The mean levels of plasma AT I and AT II in supine position were positively correlated to serum T3, and the level of plasma AT II in upright position was positively correlated to serum FT3. CONCLUSION: The level of 24 hours urine potassium output rises in THPP patients; the high levels of AT and Ald may contribute to the pathogenesis of the disease.