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患者,男性,50岁。因尿频、尿急9年,头晕、走路不稳、发作性晕厥5年入院。于9年前出现尿频、淋漓不尽,尿常规、膀胱镜检查未见异常,按前列腺炎治疗无效。5年前出现头晕、走路不稳、晕倒,经脑脊液、脑血管造影等检查未见异常。但血压(卧位)为21.3/13.3kPa。两次转上级医院,经CT等检查未确诊。曾考虑为肌病、小脑炎、高血压病、前列腺炎、侧索硬化症、脑动脉硬化、排尿性晕厥、颈椎病。症状渐重。2个月前在某军区医院诊断为Shy-Drager综合征。体查:神清,反应迟钝、吐词不清,站立不稳,四肢肌肉轻度萎缩,肌力Ⅳ°,肌张力增高,双上肢震颤,腱反射亢进,病理征+,皮
Patient, male, 50 years old. Due to frequent urination, urinary urgency 9 years, dizziness, walking instability, onset of syncope 5 years admitted. Nine years ago, frequent urination, dripping, urine routine, cystoscopy showed no abnormalities, according to prostatitis treatment ineffective. 5 years ago, dizziness, walking instability, fainting, cerebrospinal fluid, cerebral angiography and other tests showed no abnormalities. However, blood pressure (supine position) was 21.3 / 13.3 kPa. Twice go to the higher hospital, the CT examination is not diagnosed. Have considered for myopathy, encephalitis, hypertension, prostatitis, lateral sclerosis, cerebral arteriosclerosis, urinary syncope, cervical spondylosis. Symptoms become heavier. Two months ago in a military hospital diagnosis of Shy-Drager syndrome. Physical examination: clear, unresponsive, unclear articulation, standing instability, mild muscle atrophy of the limbs, muscle strength Ⅳ °, increased muscle tone, tremor in both upper extremities, tendon hyperreflexia, pathological sign +, skin