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患者 女,52岁,1990年9月入院。21年前曾患甲亢,行甲状腺次全切除术,次年复发经放射性碘治愈。18个月以前,感皮肤紧束,四肢无力,经血清学及皮肤活检等检查,诊为皮肌炎,强的松30mg/d治疗2个月,症状缓解后减至小剂量维持。12个月前现多饮、多尿、消瘦,空腹血糖>11.1mmol/L,诊为Ⅰ型糖尿病(NIDDM),间断服D_(860)1～3g/d,血糖较稳。近一月,感极度疲乏、易感冒。家族性阴性。体检:血压20/13kPa,体重40kg,皮肤粘膜无色素沉着,无突眼,甲状腺未及,心肺
Female patient, 52 years old, admitted to hospital in September 1990. Twenty-one years ago, she suffered from hyperthyroidism and underwent subtotal thyroidectomy. The following year he relapsed and healed with radioactive iodine. 18 months ago, the sense of tight skin, limb weakness, by serology and skin biopsy and other tests, diagnosed as dermatomyositis, prednisone 30mg / d treatment for 2 months, reduced to a small dose to maintain the symptoms after remission. 12 months ago more than drink, polyuria, weight loss, fasting blood glucose> 11.1mmol / L, diagnosed as type I diabetes (NIDDM), intermittent service D_ (860) 1 ~ 3g/d, blood glucose is relatively stable. In January, she was extremely tired and cold. Familial negative. Physical examination: blood pressure 20/13kPa, weight 40kg, no pigmentation of skin mucous membrane, no exophthalmos, no thyroid, heart and lung