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男患,46岁,病历号62—551。心肺结核25年,因咯血来院治疗。患病期间曾服异烟肼累计18年之久。入院后结合查体、实验室、X线检查综合分析,诊断为肺结核,并右侧陈旧性胸膜炎。住院后予以H. R. PZA方案治疗。一周后出现食欲不振、恶心、腹胀、腹泻等症状,经对症治疗后缓解。5天之后自觉全身皮肤瘙痒。查体:躯干部、四肢有分布不规则的斑丘疹,色鲜红,境界清晰,下肢伸侧皮疹密集,拟诊为湿疹,经处置无效。入院后一个月又出现烦躁不安、表情淡漠、沉默寡言、喜独处、失眠、多梦。考虑为异烟肼引起的副作用,停用异烟肼,投予VB_6治疗一周,症状未缓解,并有胸闷、心悸、气促等症状,予以谷维素治疗。以后精神症状逐日加重,
Male suffering, 46 years old, medical record number 62-551. 25 years of cardiopulmonary tuberculosis, hospitalized for treatment of hemoptysis. During the illness has been taking isoniazid for 18 years. After admission combined with physical examination, laboratory, X-ray comprehensive analysis, diagnosis of tuberculosis, and the right side of old pleurisy. H. R. PZA regimen was given after hospitalization. A week after appetite, nausea, bloating, diarrhea and other symptoms, symptomatic treatment after remission. 5 days after the conscious body itching. Physical examination: trunk, limbs have irregular rash distribution, bright red, clear realm, lower extremity rash intensive, to be diagnosed as eczema, the treatment is invalid. Appear one month after admission, irritability, apathy, dumb, hi alone, insomnia, dreams. Consider isoniazid-induced side effects, stop isoniazid, VB6 treatment for one week, the symptoms did not ease, and chest tightness, palpitations, shortness of breath and other symptoms, to oryzanol treatment. After the mental symptoms increased day by day,