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例1 患者,男性,39岁.农民,无吸烟史.因头晕、头痛一年,发热、咳嗽伴下肢无力半月,于1995年1月来院.经查血压波动24～26/14～16kPa,外院按原发性高血压治疗无效,此后反复发作咳嗽、咳痰.半月前上述症状加重,经降压,抗炎治疗三天后.患者双下肢肌无力逐渐加重.查体:T38℃,Bp26/14kPa,精神差,右肺闻及于湿性罗音,心率89次/分,早搏 5～7次/分,腹部无异常,双下肢肌力Ⅳ级,膝反射减弱,病理反射未引出.实验室检查:WBC12.8×10~9/L,NO.89,血K~+2.3mmol/L,尿醛固酮明显升高.心电图检查提示:左室肥厚伴劳损,室性早搏.胸片和肺CT均示右下肺炎.肾上腺CT示右侧肾上腺1.3×1.8cm肿块,拟诊为原发性醛固酮增多症.
Example 1 Patient, male, aged 39, farmer, no history of smoking. Because of dizziness, headache for one year, fever, cough with weakness in the lower limb half a month, came to hospital in January 1995. After checking the blood pressure fluctuations 24 ~ 26/14 ~ 16kPa, According to the treatment of primary hypertension invalid, then repeated episodes of cough, sputum .Abdominal symptoms were aggravated by antihypertensive, anti-inflammatory three days later. Patients with lower extremity muscle weakness gradually aggravated. Examination: T38 ℃, Bp26 / 14kPa , Poor spirit, the right lung smell and wet rales, heart rate 89 beats / min, premature beats 5 to 7 beats / min, no abnormal abdomen, lower extremity muscle strength grade IV, knee reflex decreased, pathological reflex did not lead to laboratory tests : WBC12.8 × 10 ~ 9 / L, NO.89, blood K ~ +2.3mmol / L, urinary aldosterone was significantly increased.Electrocardiogram showed: left ventricular hypertrophy with strain, ventricular premature beats chest X-ray and CT Show right lower pneumonia .Adrenal CT showed the right adrenal 1.3 × 1.8cm mass, to be diagnosed as primary aldosteronism.