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患者男性,76岁,因胸闷、呼吸困难、全身浮肿一周而于1989年10月13日入院。患者有高血压病、高冠心病史10年,否认高血压脑病史,精神病史及精神病家族史。体检:血压23.9/14.0kPa,颈静脉怒张,肝颈返流征阳性,心率94次/分,律不齐,可闻早搏,A_2>P_2,双下肢及腰骶部呈高度凹限性浮肿,精神神经系统未见异常。血糖、肝功能、血尿素氮及肌酐均正常。ECG示低血钾、室性早搏呈二联律。入院后经用消心痛、心痛定、双克、氨体舒通及补钾等处理,血压控制在18.6/10.6kPa上下,但心衰仍未能满意控制。入院第5天,停用淌心痛及心痛定,予以地高辛0.25mg,qd.巯甲丙脯酸12.5mg,tid,5天后心衰
Male patient, 76 years old, admitted to hospital on October 13, 1989 due to chest tightness, difficulty breathing and generalized edema. Patients with hypertension, high coronary heart disease history of 10 years, denied a history of hypertension, history of psychosis and family history of psychosis. Physical examination: blood pressure 23.9 / 14.0kPa, jugular vein engorgement, positive liver neck regurgitation, heart rate 94 beats / min, irregular, premature beats, A_2> P_2, lower limbs and lumbosacral were highly concave edema No abnormal neuropsychiatric system. Blood glucose, liver function, blood urea nitrogen and creatinine were normal. ECG showed hypokalemia, ventricular premature beriberi. Admission after the use of Xiao Hua Tong, painkillers, two grams, amifostine and potassium and other treatment, blood pressure control at 18.6 / 10.6kPa up and down, but the heart failure is still not satisfied with the control. Admission of the first 5 days, stop bleeding heartache and nifedipine, to digoxin 0.25mg, qd. Captopril 12.5mg, tid, 5 days after heart failure