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患者,男,64a。主因头晕、头重、失眠伴右侧肢体麻木一年余于1991年5月25日入院。既往有冠心病、糖尿病及腔隙性脑梗塞病史。体检:T35.5℃,P84次/min,BP14/9kPa,心率84次/min,律齐,心音有力,未闻及病理性杂音。化验:Hb149g/L,WBC 4×10~9/L,N0.49,L0.29。尿糖(+),镜检(-)。肝、肾功能均正常。血脂偏高,空腹血糖9.0mmol/L。胸透、心电图正常。诊断:1.脑动脉硬化症、2.糖尿病(中型)、3.冠心病。入院后给予扩血管药及降糖药物治疗。病人住院前因长期不良心理因素影响,精神抑郁,顽固性失眠。入院后失眠及精神抑郁加重,并出现幻听,经请精神科医生会诊,诊断为动脉硬化性精神
Patient, male, 64a. Mainly because of dizziness, head heavy, insomnia with limb numbness more than a year in May 25, 1991 admission. Past history of coronary heart disease, diabetes and lacunar infarction. Physical examination: T35.5 ℃, P84 times / min, BP14 / 9kPa, heart rate 84 beats / min, law Qi, powerful heart sounds, no smell and pathological murmur. Assay: Hb149g / L, WBC 4 × 10 ~ 9 / L, N0.49, L0.29. Urine (+), microscopic examination (-). Liver, kidney function are normal. Hyperlipidemia, fasting glucose 9.0mmol / L. Chest throat, normal ECG. Diagnosis: 1. Cerebral arteriosclerosis, 2. Diabetes (medium), 3. Coronary heart disease. After admission, vasodilators and antidiabetic drugs were given. Patients before hospital due to long-term adverse psychological factors, depression, intractable insomnia. After admission, insomnia and depression increased, and auditory hallucinations, psychiatrists consulted, diagnosed as arteriosclerosis