《中国康复理论与实践》

《中国康复理论与实践》 ›› 2014, Vol. 20 ›› Issue (6): 585-587.

• 论文 • 上一篇    下一篇

甲状旁腺功能减退症继发低钙性肌病的临床分析

王锁彬，张津   

  1. 首都医科大学宣武医院神经内科，北京市100053
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2014-06-25 发布日期:2014-06-25

Clinical Features of Hypocalcemic Myopathy Secondary to Hypoparathyroidism

WANG Suo-bin, ZHANG Jin.   

  1. Department of Neurology,Xuanwu Hospital, Capital Medical University, Beijing 100035, China
  • Received:1900-01-01 Revised:1900-01-01 Published:2014-06-25 Online:2014-06-25

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摘要： 目的观察甲状旁腺功能减退症继发低钙性肌病的临床特征。方法对13 例甲状旁腺功能减退症继发低钙性肌病患者的临床表现、实验室检查特点和治疗方法进行回顾。结果13 例患者分别为原发性甲状旁腺功能减退症8 例，继发性3 例，假性2 例。继发低钙性肌病表现为发作性手足搐搦，发作性双手足、前臂、小腿痉挛且疼痛，还可见眼睑痉挛、躯干痉挛、咽喉痉挛。
部分患者Trousseau 征和Chvostek 征阳性。血清肌酸激酶、乳酸脱氢酶水平升高。经给予足量碳酸钙和骨化三醇治疗，患者肌肉病症状缓解，肌酶恢复正常。结论原发性、继发性或假性甲状旁腺功能减退症均可引起低钙血症，导致肌肉疾病，补充足量碳酸和骨化三醇有效。

关键词: 甲状旁腺功能减退症, 低钙血症, 肌病, 肌酸激酶

Abstract: Objective To observe the features of hypocalcemic myopathy secondary to hypoparathyroidism (HP). Methods The symptoms and signs, laboratory findings and treatments of 13 patients with hypocalcemic myopathy secondary to HP were analyzed retrospectively. Results 13 cases of HP were classified into idiopathic HP (8 cases), secondary HP (3 cases) and pseudo-HP (2 cases). The symptoms of hypocalcemic myopathy secondary to HP included tetany, episodic carpopedal spasm, muscle cramps and myalgias in the forearms and calves. It presented blepharospasm, trunk spasm and laryngospasm. Some patients demonstrated positive Trousseau's and Chvostek's sign. Serum level of creatine kinase (CK) and lactate dehydrogenase (LDH) increased. The symptoms of myopathy released and the levels of CK and LDH decreased to normal level after enough calcium carbonate and calcitriol administration. Conclusion All types of HP (idiopathic, secondary and pseudo HP) can cause hypocalcemia and myopathy. Hypocalcemic myopathy secondary to HP would well recover by enough calcium carbonate and calcitriol treatment.

Key words: hypoparathyroidism, hypocalcemia, myopathy, creatine kinase