长程运动诱发试验的两种方法在诊断低钾性周期性麻痹中的比较

摘要 目的：探究长程运动诱发试验（exercise test, ET）的两种方法在诊断低钾性周期性麻痹患者的价值比较。方法：选择2018年2月~2020年3月我院住院和门诊的72例低钾性周期性麻痹患者，根据ET检测的方法分为观察组和对照组，对比两组ET检测在运动后即刻、运动后的10、20、30、40、50、60 min的双侧尺神经进行复合肌肉动作电位（compound muscle action potential，cMAP）波幅和ET阳性率；以临床诊断结果为金指标，分析两组ET诊断价值。结果：两组的ET检测的阳性发生率对比无显著性差异（P>0.05）。两组波幅降低百分比在运动后即刻以及运动后的10、20、30、40、50、60 min对比无差异(P>0.05)，在20 min后观察组波幅降低百分比趋势稍比对照组慢。临床诊断结果阳性68例，阳性率为94.44 %。观察组ET检测的特异性为50.0 %，灵敏度为88.23 %，对照组ET检测的特异性为25.0 %，灵敏度为80.88 %，观察组的特异性和灵敏度均优于对照组。结论：长程运动诱发试验是低钾型周期性麻痹诊断中重要的辅助诊断方法之一，且运动持续50 s，休息10 s，只做1个循环的方法，简单、快捷，可供临床诊断时优先选择。

Diagnostic Value of Long-range Exercise-induced Experiments for Hypokalemic Periodic Paralysis

ABSTRACT Objective: Explore the diagnostic value of long-term exercise induction test (ET) for patients with hypokalemic periodic paralysis. Methods: 72 patients with hypokalemia periodic paralysis in our hospital from February 2018 to March 2020 were selected. They were divided into the observation group and the control group according to the method of ET detection. Compare the two groups of ET detection immediately after exercise, exercise after 10, 20, 30, 40, 50, and 60 min, the bilateral ulnar nerves performed compound muscle action potential (cMAP) amplitude and ET positive rate, the clinical diagnosis results were used as gold indicators to analyze the two groups of ET Diagnostic value. Results: There was no significant difference in the positive incidence of ET test between the two groups(P>0.05). There was no difference in the percentage of amplitude reduction between the two groups immediately after exercise and at 10, 20, 30, 40, 50, and 60 minutes after exercise(P>0.05). After 20 minutes, the percentage of amplitude decrease in the observation group was slightly slower than that in the control group. 68 cases had a positive clinical diagnosis, and the positive rate was 94.44 %. The specificity of ET in the observation group was 50.0 %, and the sensitivity was 88.23 %. The specificity of ET in the control group was 25.0 %, and the sensitivity was 80.88 %. The specificity and sensitivity of the observation group were better than the control group. Conclusion: The long-range exercise induction test was one of the important auxiliary diagnostic methods in the diagnosis of hypokalemic periodic paralysis, and the ET exercise lasts 50 s, rests for 10 s, and only one cycle is done. It was simple and fast, and is available for clinical diagnosis select.