论文部分内容阅读
患者 男,60岁。患者患“高血压病”20余年及“糖尿病”9年,长期服用降糖药及降压药,此次因恶心、呕吐2天于1989年2月17日入院。入院时体检:T36.7℃,P112次/分,R20次/分,BP180/90mmHg。贫血貌,烦躁,意识清楚,精神差。全身水肿。心界不大,心音减弱,心律齐,心尖区可闻及Ⅱ级收缩期杂音。腹平软,肝右肋下2cm,质软。余无异常发现。实验室检查:血糖12.4mmol/L,尿糖(卅),酮体阳性,尿蛋白(卅)。血红蛋白75g/L,血肌酐367μmol/L,尿素氮11.3mmol/L,总蛋白48g/L,白蛋白24g/L,球蛋白23g/L。B型超声波检查:肝肿大、回声异常;双肾回声异常;少量腹水及心包积液。
Male patient, 60 years old. Patients suffering from “hypertension” for more than 20 years and “diabetes” for 9 years, long-term use of hypoglycemic agents and antihypertensive drugs, the nausea, vomiting for 2 days in February 17, 1989 admission. Physical examination on admission: T36.7 ℃, P112 times / min, R20 beats / min, BP180 / 90mmHg. Anemia appearance, irritability, awareness, poor spirit. Body edema. Heart, heart sounds weakened, heart rate Qi, apex area can be heard and Ⅱ systolic murmur. Abdomen soft, right ribs 2cm, soft. I found no abnormalities. Laboratory tests: blood glucose 12.4mmol / L, urine sugar (卅), ketone body positive, urinary protein (卅). Hemoglobin 75g / L, serum creatinine 367μmol / L, urea nitrogen 11.3mmol / L, total protein 48g / L, albumin 24g / L, globulin 23g / L. B-mode ultrasound: hepatomegaly, echo abnormalities; bilateral renal echo abnormalities; a small amount of ascites and pericardial effusion.