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例1 男,22岁,多食,易饥,心悸,乏力,消瘦3年余,于1986年8月19日住院。查体:T 37.4℃,R 24次/分,P120次/分,BP 14.7/9.33kPa(110/70mmHg)。甲亢眼征阴性,甲状腺Ⅰ度肿大,可闻及血管杂音。手颤试验阳性。BMR+30％,甲状腺~(131)Ⅰ摄取率增高,T_3 3.4nmol/L、T_4 165nmol/L,心电图示窦性心动过速。诊断:甲状腺机能亢进症,给予他巴唑治疗。患者于9月13日傍晚久坐后,感全身乏力、酸软,继而四肢活动受限。查体:双上肢肌力Ⅱ度,双下肢肌力0,肌张力低。膝反射消失。未引出病理反射。急查血钾2.4mmol/L,心电图:电解质紊乱,低血钾,Ⅰ度房室传导阻滞(AVB)。即刻静脉补钾,5小时后肌力逐渐恢复,次日可下床活动。复查心电图Ⅰ度AVB消失。
Example 1 Male, 22 years old, eat more, easy to hunger, palpitations, fatigue, weight loss more than 3 years, in August 19, 1986 hospitalization. Examination: T 37.4 ℃, R 24 beats / min, P120 beats / min, BP 14.7 / 9.33kPa (110 / 70mmHg). Hyperthyroidism eye symptoms negative, thyroid Ⅰ degree swollen, can be heard and vascular murmur. Hand tremor test positive. BMR + 30%, thyroid uptake of 131I increased, T_3 3.4nmol / L, T_4 165nmol / L, ECG showed sinus tachycardia. Diagnosis: Hyperthyroidism, given methimazole treatment. After sedentary on the evening of September 13, the patient was feeling weak, sour and soft, and his limbs were limited. Physical examination: double upper limb muscle strength Ⅱ, lower extremity muscle strength 0, low muscle tone. Knee reflex disappeared. Did not lead to pathological reflex. Rapid check serum potassium 2.4mmol / L, ECG: electrolyte imbalance, hypokalemia, Ⅰ degree atrioventricular block (AVB). Immediate intravenous potassium, 5 hours after the gradual recovery of muscle strength, the next day can get out of bed activity. Review ECG Ⅰ degree AVB disappeared.