论文部分内容阅读
患者男,60岁,住院号210606,1987年10月19日入院。入院前3天,自觉心慌、胸闷、心前区不适,但无胸痛,自服硝酸甘油等药物无效。高血压病史13年,血压波动在160～190/100～140mmHg,经常服用降压药。入院体检:T36.5℃,BPl70/100mmHg,发育及营养正常,颈静脉无怒张,心界不大,心率100次/分,律齐,心尖区闻及吹风样Ⅱ级收缩期杂音。两肺正常。腹平软,肝、脾未及,未扪及包块。实验室检查:尿、粪、血常规和肝功能均正常。胸透心肺正常。血胆固醇6.13mmol/L,甘油三脂1.09mmol/L,血清电解质在正常范围内,血清LDH 81.8μmol.S~(-1)/L。心电图:V_1及V_2呈QS型,V_3呈rS型,ST_(v_1)抬高2mm、v_2及V_3抬高4mm,T_(v_1)～v_3倒置。入院后经卧床休息、吸氧,应用心痛定、消心痛及抗心律失常药物治疗,胸闷缓解,但血压不稳定,有时达到230/150mmHg。酚妥拉明试验阳性,尿
Male patient, 60 years old, hospital number 210606, was admitted to hospital on October 19, 1987. 3 days before admission, conscientious flustered, chest tightness, precordial discomfort, but no chest pain, self-service nitroglycerin and other drugs invalid. Hypertensive history of 13 years, blood pressure fluctuations in the 160 ~ 190/100 ~ 140mmHg, often taking antihypertensive drugs. Admission medical examination: T36.5 ℃, BPl70 / 100mmHg, normal development and nutrition, no jugular vein engorgement, heart, heart rate 100 beats / min, law Qi, apex area smell and hair style Ⅱ systolic murmur. Normal lungs. Abdomen soft, liver, spleen yet, palpable mass. Laboratory tests: urine, feces, blood and liver function are normal. Chest heart and lung normal. Blood cholesterol 6.13mmol / L, triglyceride 1.09mmol / L, serum electrolytes in the normal range, serum LDH 81.8μmol.S ~ (-1) / L. ECG: V_1 and V_2 were QS type, V_3 was rS type, ST_ (v_1) elevation 2mm, v_2 and V_3 elevation 4mm, T_ (v_1) ~ v_3 inversion. After hospital stay after bed rest, oxygen, application of nifedipine, anti-heartburn and anti-arrhythmic drug treatment, chest tightness relief, but the blood pressure is unstable, sometimes up to 230 / 150mmHg. Phentolamine test positive, urine