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病例介绍陈某,男,36岁,农民。自诉1982年初起觉两小腿酸胀,抬腿迈步须待片刻后才能动作;同时有两手持物或握拳后不易放松动作迟缓,天冷或劳累后加重,反复活动后可暂时减轻。近半年来前额脱发明显,四肢无力变细,说话慢,发音不清,两眼视物模糊,食欲和性欲减遐。家族中胞妹有类似疾病,其余亲属尚好。入院体检:营养欠佳,头发以前额脱落明显,眉毛、腋毛、阴毛稀疏。甲状腺不大,心肺无明显异常,肝脾未触及,两侧睾丸细小,质软无压痛无结节,阴茎短小。两侧颞肌及面颊肌萎缩。两侧胸锁乳突肌萎缩如索条样,胸大肌、三角肌及冈上、下肌均有明显萎缩,无肌纤维震颤。握拳力量差,测放松时间左手5
Case introduction Chen, male, 36 years old, farmer. Prosecutors in early 1982, the two legs soreness, leg lift to be a moment later to move; at the same time there are two hand or clenched after the slow movement is not easy to relax, cold or tired after repeated activities can be temporarily reduced. Forehead hair loss in the past six months significantly, extremities weakness, slow speech, unclear pronunciation, blurred vision, loss of appetite and sexual desire ya. Family sister has a similar disease, the rest of the relatives is still good. Admission medical examination: poor nutrition, hair forehead off significantly, eyebrows, armpit hair, pubic hair sparse. Small thyroid, heart and lung no obvious abnormalities, liver and spleen not touched, small testes on both sides, soft without nodules, penis short. Both temporal muscle and cheek muscle atrophy. Sternocleidomastoid muscle atrophy on both sides, such as cable-like, pectoralis major, deltoid and supraspinatus, inferior muscular were significantly atrophic, no muscle fiber tremor. Fight strength is poor, measured relaxation time left 5