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患者男性,48岁。以左侧肢体活动障碍伴失语半天于1995年3月6日入院。体检:T37.6C(腋下),P92次/分,R20次/分,BP20/10kPa。神志清,两眼明显突出,瞳孔3mm,对称,对光反应敏感,左鼻唇沟变浅,伸舌未偏。颈软,甲状腺Ⅱ度肿大,闻及血管杂音。颈静脉无怒张,心率112次/分,心律绝对不规则,心尖区Ⅱ级收缩期杂音,心浊音界向左略扩大,两肺听诊正常。腹平软,肝肋下2cm,脾未及,肾区无叩痛,下肢无浮肿。左侧上下肢肌力Ⅲ级。肌张力正常,腱反射活跃。克匿格征(一),巴彬斯基征(一)。实验室检查:Hb 87g/L,WBC4.4×10~9/L,N 0.75,L 0.25,血小板数52×10~9/L,ESR 5mm/h,总胆红素34.2μmol/L(正常0.9～20μmol/L),直接胆红素6.84μmol/L(正常0～6.8μmol/L),ALT47IU/L,血糖4.94nmol/L,胆固醇1.84mmol/L,甘油三酯0.35mmol/L,ASO<500IU,
Male patient, 48 years old. Left limb movement disorders with aphasia for a long time in March 6, 1995 admission. Physical examination: T37.6C (armpit), P92 times / min, R20 beats / min, BP20 / 10kPa. Consciousness, two prominent conspicuous, pupil 3mm, symmetrical, sensitive to light, the left nasolabial fold shallow, stretch the tongue is not partial. Neck soft, thyroid enlargement Ⅱ, smell and vascular murmur. Jugular vein without anger, heart rate 112 beats / min, heart rate is absolutely irregular, apex systolic murmur Ⅱ, diastolic heart sound left to expand slightly, both lung auscultation normal. Abdomen soft, liver ribs 2cm, spleen and kidney area without percussion pain, lower extremity no edema. Left and right lower extremity muscle strength Ⅲ. Muscle tension normal tendon reflexes. Ke anger sign (a), Babinski sign (a). Laboratory tests: Hb 87 g / L, WBC 4.4 × 10 9 / L, N 0.75, L 0.25, platelet count 52 × 10 9 / L, ESR 5 mm / h and total bilirubin 34.2 μmol / L 0.9 ~ 20μmol / L), direct bilirubin 6.84μmol / L (normal 0 ~ 6.8μmol / L), ALT47IU / L, blood glucose 4.94nmol / L, cholesterol 1.84mmol / L, triglyceride 0.35mmol / <500IU,