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患男,47岁,发热,全身酸痛腰痛4d。否认心、肾病史。查体:T38.3℃,P88次/min,R22次/min,BP13/9kPa。神志清,面潮红,全身皮肤粘膜无出血点,球结膜明显充血水肿,心、肺正常,肝、脾未触及,双肾区叩击痛。实验室检查:WBC25.6×10~9/L,N0.78,异淋0.20,Hb178g/L,BPC45×10~9/L;尿有膜状物,蛋白(+++),RBC(++);肾功BUN16.4mmol/L,Cr158.4μmol/L;出血热抗体阳性。诊断为流行性出血热(发热期)。入院后给抗病毒、降温、补液、利尿等治疗血压稳定在14/11kPa,跨越少尿期,住院第5天进入多尿期,第8天尿量最多达600ml,于病程第7天出现心悸,胸闷,气短,心率44～50次/min,动态心电图示:窦性心动过缓,高度房室传导阻滞;血清电解质正常。即给阿托品0.3mg口服,3次/d;氢化可的松20mg
Male, 47 years old, fever, body aches back pain 4d. Neglect, kidney disease history. Examination: T38.3 ℃, P88 times / min, R22 times / min, BP13 / 9kPa. Consciousness, flushing, skin mucosa without bleeding, conjunctival obvious congestion and edema, heart, lungs normal, liver, spleen not touched, peritoneal area percussion pain. Laboratory examination: WBC25.6 × 10 ~ 9 / L, N0.78, different leaching 0.20, Hb178g / L, BPC45 × 10 ~ 9 / L; urine membranous protein (+++), RBC (+ +); Renal function BUN16.4mmol / L, Cr158.4μmol / L; hemorrhagic fever antibody positive. Diagnosis of epidemic hemorrhagic fever (fever period). Admission to the hospital after antiviral, cooling, rehydration, diuretic and other treatment of blood pressure stabilized at 14 / 11kPa, across the oliguria, admission to the first five days of polyuria, the first eight days of urine up to 600ml, 7 days in the course of heart palpitations , Chest tightness, shortness of breath, heart rate 44 ~ 50 times / min, Holter: sinus bradycardia, atrioventricular block; serum electrolyte normal. Atropine 0.3mg orally, 3 times / d; hydrocortisone 20mg