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患者男,33岁,农民.因乏力、多食、进行性消瘦3个月,反复昏厥1天于1990年10月13日入院.3个月前无明显诱因下出现乏力、多食、进行性消瘦,近来症状加重伴心悸、胸闷、头昏、气憋,未医治.入院当天出现短暂晕厥伴抽搐3次,每次约30秒至1分钟、体检:T36.8℃,BP17.33/8.0kPa,两眼微突,甲状腺弥漫性Ⅱ度肿大,闻及血管杂音,心率52次/分,节律不规则,心尖区闻及Ⅱ～Ⅲ级收缩期杂音,心界不大,两肺听诊正常,肝肋下1.5cm,质软,无触痛,脾未及,余无殊.实验室检查;血清钾、钠、氯、钙、镁均正常,血BUN7.9mmol/L,Cr 212.2μmol/L,空腹血糖5.47mmol/L,血LDH352u,GOT < 40u,ESR24mm/h,IgG1431IU/L,IgA1056IU/I,IgM2361lU/L,T_4 314.67nmol/L,T_3 1.74nmol/L,rT_3 6.97nmol/L,TSH0.022mIU/L,T_3MAA1.08,心电图示Ⅲ度房室传导阻滞(AVB)伴交界性选搏心律,心率48次/分,B超示心脏正常,心脏三位片示心脏稍增大.诊断为甲亢并发Ⅲ度AVB伴阿-
Male patient, 33 years old, farmer. Due to fatigue, eating more, progressive weight loss for 3 months, repeated fainting 1 day admitted to hospital on October 13, 1990. 3 months ago, there was no obvious incentive to fatigue, eat more, progressive Weight loss, recent symptoms aggravated with palpitations, chest tightness, dizziness, gas hold back, did not heal .Patient syncope with convulsions on the day 3 times, each about 30 seconds to 1 minute, physical examination: T36.8 ℃, BP17.33 / 8.0 kPa, two micropyridses, diffuse thyroid diffuse degree II, smell and vascular murmur, heart rate 52 beats / min, irregular rhythm, apex area smell and Ⅱ ~ Ⅲ systolic murmur, heart is not big, both lung auscultation Normal, hepatic ribs 1.5cm, soft, no tenderness, spleen and no special laboratory tests; serum potassium, sodium, chloride, calcium and magnesium were normal blood BUN7.9mmol / L, Cr212.2μmol / L, fasting blood glucose 5.47mmol / L, blood LDH352u, GOT <40u, ESR 24mm / h, IgG1431IU / L, IgA1056IU / I, IgM2361lU / L, T_4 314.67nmol / L, T_3 1.74nmol / L, rT_3 6.97nmol / L , TSH0.022mIU / L, T_3MAA1.08, ECG third degree atrioventricular block (AVB) with borderline beating heart rate, heart rate 48 beats / min, B ultrasound showed normal heart, Large diagnosed as hyperthyroidism complicated with Ⅲ AVB with A -