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患者男性,20岁,临床诊断:肾病综合征。检查:全身浮肿,BP120/80mmHg,心肺(-),腹水(+)。实验室:24h尿蛋白定量4000mg,血钾2.32mmol/L,CO_2CP16.2mmol/L(36Vol%),BUN21.2mmol/L(59mg/dl),血A/G为2.5:3.5,胆固醇12.35mmol/L(475mg/dl)。心电图表现:P波为房性,另Ⅲ导联可见窦性搏动及房性融合波(P_5),异位节律约90次/min,心电轴0°,诊断为加速性房性自搏心律(图1)。行阿托品试验(静注1.0mg)中心率加快,P波渐由负正双向转直立,QRS波形态亦由RS转为rS型(图2)。注射
Patient Male, 20 years old, clinical diagnosis: nephrotic syndrome. Check: whole body edema, BP120 / 80mmHg, cardiopulmonary (-), ascites (+). Laboratory: 24h urine protein quantitation 4000mg, potassium 2.32mmol / L, CO 2 CP 16.2mmol / L (36Vol%), BUN 21.2mmol / L (59mg / dl), blood A / G 2.5: 3.5, cholesterol 12.35mmol / L (475 mg / dl). ECG showed: P wave is atrial, and the other leads showed sinus pulsatility and atrial fusion (P_5), ectopic rhythm of about 90 beats / min, ECG axis 0 °, diagnosed as accelerated atrial pacemaker (figure 1). Line atropine test (intravenous injection of 1.0mg) to speed up the center, P wave gradually positive and negative bidirectional turn up, QRS waveform also changed from RS to rS type (Figure 2). injection