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1 临床资料 患者男性,48岁,市民。因乏力、头疼1周,站立不稳2d入院。既往患“高血压”5年,现服“降压零号”;患“银屑病”12年。查体:体温36.1℃,心率67次/min,血压180/90 mm Hg。四肢及胸背有多处大小不等呈地图状淡红色斑疹,约占体表面积的45％。表面覆有多层银白色鳞屑及抓痕,无明显异味。心、肺听、叩诊正常,腹部检查未见异常。表情淡漠,语言流利。左侧瞳孔直径2mm,圆,对光反射迟钝;右侧瞳孔直径4mm,圆,对光反射佳,颅神经功能正常。双上肢肌力Ⅴ级,双下肢肌力Ⅳ级,腱反射对称略减弱。没有银屑病变处的皮肤深浅感觉正常,共济运动正常,无脑膜刺激征。实验室检查
1 clinical data patients male, 48 years old, the public. Due to fatigue, headache for 1 week, standing firm 2d admission. Previously suffering from “high blood pressure” 5 years, is serving “blood pressure zero”; suffering from “psoriasis” for 12 years. Physical examination: body temperature 36.1 ℃, heart rate 67 beats / min, blood pressure 180/90 mm Hg. Extremities and chest and chest vary in size from map light red rash, accounting for about 45% of the body surface area. Surface covered with multiple silver-white scales and scratches, no obvious odor. Heart, lungs, percussion normal, no abnormal abdominal examination. Indifferent expression, fluent language. Left pupil diameter 2mm, round, slow light reflex; right pupil diameter 4mm, round, good light reflection, normal cranial nerves. Double upper limb muscle strength grade Ⅴ, lower limb muscle strength grade Ⅳ, tendon reflex slightly weakened symmetry. No psoriasis at the skin depth and feel normal, Masonic motor normal, no meningeal irritation. Laboratory examination