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患者,男、45岁。因双下肢乏力进行性加重1年余,于1987年8月31日入院。曾在外地医院诊为侧索硬化症、肝炎后肝硬化、脾功能亢进,20余年前因胆石症而行胆囊切除手术,近十年来肝功能不正常。查体:T36℃,P64次/分,R18次/分,BP20.0/13.3kPa。双上肢肌力腱反射(++)双下肢可见有肌束震颤肌力远端等于近端Ⅳ·,肌张力增高,呈痉挛步态,双侧髂前上棘以下音叉振动觉减弱,双侧膝腱反射及跟腱反射(+++),踝震挛(+),提睾反射存在,双侧巴氏征(+),chadd-ock(+),肝未及,脾肋下3cm可及。腰穿脑压125mmH_2O,奎根氏试验示椎管通畅,脑脊液:常规正常,免疫球蛋白IgG0.38mg%。AFP<50ng/ml。BUN 18.8mg%,血沉3mm/h,总蛋白
Patient, male, 45 years old. Due to weakness of both lower extremities progressive aggravate more than 1 year, was admitted on August 31, 1987. Have been diagnosed in the field hospital as lateral sclerosis, posthepatitis cirrhosis, hypersplenism, more than 20 years ago because of cholelithiasis and cholecystectomy, liver function over the past decade abnormal. Physical examination: T36 ℃, P64 beats / min, R18 beats / min, BP20.0 / 13.3kPa. Double upper extremity tendon reflexes (++) Lower extremity visible muscle tremor muscle strength distal equal to the proximal Ⅳ ·, muscle tension increased, was spastic gait, bilateral anterior superior iliac spike below the tuning fork vibration weakened, both sides Knee tendon reflex and Achilles tendon reflex (+ +), ankle clonus (+), crestal reflex, bilateral Pakistan’s sign (+), chadd-ock and. Lumbar puncture brain pressure 125mmH_2O, Kugel’s test showed spinal canal patency, cerebrospinal fluid: routine normal, immunoglobulin IgG0.38mg%. AFP <50ng / ml. BUN 18.8mg%, ESR 3mm / h, total protein