患者男,51岁,病例号11133,糖尿病史11年。1年前无诱因出现乏力、畏寒、纳差,本次因高热入院。入院查体:慢性病容,中度贫血貌,体瘦,皮肤干燥,肢凉,粘膜苍白,无出血点,甲状腺无肿大触痛、及血管杂音。双肺叩实音,听诊可闻及散在干湿罗音,心率60次/分,心音略低,节律整,腹平软,踉腱反射减弱。辅助检查:血常规WBC6.5×10~9/L,Hb80g/L,RBC2.50×10~(12)/L,pc300×10~9/L。T_4<20μg/dl,T_3<0.5ng/ml。血糖10.4mmol/L,尿糖卅,蛋白(一),酮体(一)。胸片为肺结核。B超可见甲状腺萎缩。临床诊断:1、糖尿病(Ⅱ型),2、甲状腺功能减退症,3、肺结核。 Patient male, 51 years old, case number 11133, history of diabetes 11 years. 1 year ago, no incentive to appear fatigue, chills, anorexia, the hospital admission due to fever. Admission examination: chronic disease, moderate anemia appearance, body thin, dry skin, cold limbs, mucosal pale, no bleeding, no swelling of the thyroid tenderness, and vascular murmur. Pulmonary tapping real tone, auscultation can be heard and scattered in wet and dry rales, heart rate 60 beats / min, heart sounds slightly lower, rhythm whole, abdominal soft, weakened tendon reflex. Auxiliary examination: blood WBC 6.5 × 10 ~ 9 / L, Hb80g / L, RBC2.50 × 10 ~ (12) / L, pc300 × 10 ~ 9 / L. T_4 <20μg / dl, T_3 <0.5ng / ml. Blood sugar 10.4mmol / L, urine sugar, protein (a), ketone body (a). Chest radiography for tuberculosis. B-visible thyroid atrophy. Clinical diagnosis: 1, diabetes (type Ⅱ), 2, hypothyroidism, 3, tuberculosis.