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患者女,48岁,农民,病案号:114302.患者自1986年5月发现颈部增大,并伴有心悸、多汗、乏力、消瘦等症状而来就诊。当时体检:甲状腺Ⅱ°肿大,两侧均可闻及血管杂音,两手细颤,心率96次/分,血清T_3>12.32nmol/L,T_4302 nmol/L,甲状腺~(131)Ⅰ吸收率2小时0.91,6小时0.89,24小时0.78。经不规则服用他巴唑治疗一年后,自行中断治疗。两个月后患者再次出现上述症状,同时伴有进行性声音嘶哑,烦渴,多饮,全身乏力,生活不能自理。于1987年11月住院治疗。入院后体检:除上述症状外,见四肢肌肉萎缩,尤以双手大、小鱼际肌明显,双下肢下蹲后无力站起,双手
Female patient, 48 years old, farmer, medical record number: 114302. Patients since May 1986 found that the neck increases, accompanied by palpitations, sweating, fatigue, weight loss and other symptoms from the treatment. At that time, the examination showed that thyroid Ⅱ ° swollen, both sides of the thyroid gland could be heard with vascular murmur, both hands tremor, heart rate 96 beats / min, serum T_3> 12.32nmol / L, T_4302nmol / L, thyroid 131I absorption rate 2 Hour 0.91, hour 6 0.89, hour 24 0.78. After an irregular treatment with methimazole one year, discontinue treatment on their own. Two months later, the patient again appeared in the above symptoms, accompanied by progressive hoarseness, polydipsia, polydipsia, malaise, life can not take care of themselves. In November 1987 hospitalization. Physical examination after admission: In addition to the above symptoms, see the limbs muscle atrophy, especially in the hands of large, small atresia obvious, unable to stand up after both legs squatting, hands