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患者男性,64岁.因心前区持续疼痛伴头昏、恶心2h入院.既往有高血压病史16年,冠心病史6年.体检:神志清楚,血压18/13kPa,心界稍向左下扩大,心率69bpm,心音低钝,早搏3～5次/min,各瓣膜区未闻及杂音.肺、肝、脾及神经系统检查无异常.化验:谷草转氨酶490IU/L,肌酸磷酸激酶896IU/L,乳酸脱氢酶2093IU/L(酶法).心电图Ⅱ,Ⅲ导联呈QR型,ST_Ⅱ上升0.5mV,ST_Ⅲ上升0.6mV,提示:急性下壁心肌梗塞.立即给予尿激酶70万U静滴,次日起每日静滴尿激酶30万U.第5d患者突然出现左侧中枢性舌瘫及中枢性偏瘫,左侧上下肢肌力为Ⅰ级.神志清楚.初步诊
Male patient, aged 64. Because of persistent pain in the precordial area with dizziness, nausea 2h admission. Previous history of hypertension 16 years, history of coronary heart disease 6 years. Physical examination: conscious, blood pressure 18 / 13kPa, the heart slightly lower left to expand , Heart rate 69bpm, heart sound low blunt, premature beats 3 to 5 times / min, the valve area is not heard and murmur.Lungs, liver, spleen and nervous system examination was normal.Experiment: Aspartate aminotransferase 490IU / L, creatine phosphokinase 896IU / L, lactate dehydrogenase 2093IU / L (enzyme method.) ECG QR Ⅱ type, QR type ST_Ⅱ increased 0.5mV, ST_Ⅲ increased 0.6mV, suggesting that: acute inferior myocardial infarction immediately given urokinase 700000 U static Drip, the next day daily intravenous infusion of urokinase 300000 U. 5d patients suddenly appear in the left central and central hemiplegia, upper left and right lower extremity muscle strength grade I. Conscious clinic.