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患者,男性,58岁,既往高血压病史2年,糖尿病史1年。长期口服降压药卡托普利、心痛定,降糖药降糖灵、消渴丸等治疗。入院前2年,因患急性胃肠炎,饮食欠佳,常规口服降糖药物,出现头晕、烦躁、心慌、语言障碍,左侧肢体活动受限。在当地卫生院诊断为脑梗死,给以静点扩血管药物治疗,症状无好转,来我院。查体:神志清楚,BP:165/100mmHg,P:78次/min,R:20次/min,双瞳等大,颈软,双肺呼吸音清,心率78次/min,律齐,无杂音。左侧肢肢体肌力Ⅲ级,肌张力正常,左侧巴氏征阳性。急查头颅CT,未见异常。血糖:2.0mmol/L。肝功能:谷草转氨酶:86u/L,谷丙转氨酶42u/L。肾功能:尿素氮7.2mmol/L。肌酐:144mmol/L。诊断:低血糖。治疗,以50%葡萄糖60ml静脉推注,症状逐
Patient, male, 58 years old, history of previous hypertension 2 years, history of diabetes 1 year. Long-term oral antihypertensive drugs captopril, nifedipine, hypoglycemic agents hypoglycemic, Xiaoke Pill and other treatment. 2 years before admission, due to acute gastroenteritis, poor diet, oral hypoglycemic drugs, dizziness, irritability, palpitation, language problems, restricted limb activity. In the local hospital diagnosis of cerebral infarction, to intravenous vasodilator drug treatment, no improvement in symptoms, to our hospital. Examination: conscious, BP: 165 / 100mmHg, P: 78 times / min, R: 20 times / min, double pupil and other large, soft neck, lung breath sounds clear, heart rate 78 beats / min, Noise. Left limb limb muscle strength Ⅲ grade, normal muscle tone, positive left Pakistan’s sign. Emergency head CT, no abnormalities. Blood sugar: 2.0mmol / L. Liver function: Aspartate aminotransferase: 86u / L, alanine aminotransferase 42u / L. Renal function: urea nitrogen 7.2mmol / L. Creatinine: 144 mmol / L. Diagnosis: hypoglycemia. Treatment, intravenous injection of 60ml 50% glucose, the symptoms by