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患者男,61岁,嗜睡半年,加重三月,于1996年6月25日入院。既往无肾脏病史,否认应用肾毒性抗生素、重金属等药物。查体:表情淡漠,反应迟钝,贫血貌,面色灰暗、干燥;双肺呼吸音增强,心尖搏动于剑突下明显,心界向双侧扩大,A_2亢进,二尖瓣、三尖瓣、主动脉瓣听诊区可闻及Ⅲ级收缩期杂音;腹软,肝脾未触及,双肾区叩痛,肠鸣音正常;腱反射减弱,四肢肌力Ⅳ级,双手抬举时震颤。血液检查:WBC 8.8×10~9/L,Hb70g/L,钾4.7mmol/L,钙2.0mmol/L.CO_2CP 9.0mmol/L,BUN 33mmol/L,Cr 890μmol/L;尿比重1.010,蛋白(++),白细胞0～1,红细胞1～2;心电图:顺钟向转位、Ⅰ°房室传导阻
Male patient, 61 years old, drowsiness six months, increased in March, was admitted to hospital on June 25, 1996. No previous history of kidney disease, denied the application of nephrotoxic antibiotics, heavy metals and other drugs. Physical examination: indifferent expression, unresponsive, anemic appearance, looking dull, dry; lung breath sounds increased, apical beating significantly in the xiphoid, heart bound to bilateral enlargement, A 2 hyperthyroidism, mitral, tricuspid, the main Aortic valve auscultation area can be heard and Ⅲ systolic murmur; abdomen soft, liver and spleen not touched, renal percussion pain, bowel sounds normal; weakened tendon reflexes, muscle strength Ⅳ limbs, both hands tremor when the lift. Blood test: WBC 8.8 × 10 ~ 9 / L, Hb70g / L, potassium 4.7mmol / L, calcium 2.0mmol / L.CO_2CP 9.0mmol / L, BUN 33mmol / L, Cr 890μmol / ++), leukocytes 0 ~ 1, red blood cells 1 ~ 2; ECG: cis transposition, Ⅰ ° atrioventricular block resistance