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患者 男,28岁,农民。因间歇抽搐伴意识障碍2个月,全身红斑并发热6天于1994年12月3日入院。近2个月来患者无诱因发作全身抽搐伴意识障碍5次,每次持续3～5分钟后缓解。当地以中药治疗无效,改服苯妥英钠1.2g/d,2周后症状控制。近1周来患者全身泛发红斑,口腔糜烂伴发热而入院。查体:T 36.5℃,P40次/分,R 20次/分,BP 11/7kPa(82.5/52.5mmHg),急性病容,意识模糊,构音困难,瞳孔对光反射迟钝,巩膜黄染,口腔粘膜散在糜烂,颈部稍有抵抗,全身皮肤泛发绛色红斑,部分融合,压之退色。双肺呼吸音清晰,心界不大,心率40次/分,律齐、无杂音。肝肋缘下3cm,压痛,脾脏不大,腹水征阴性。血常规正常;尿:蛋白(++),RBC 4～8/HP;BUN 8.9mmol/L,GPT 200U,肌酸磷酸激酶(CPK)300U/L,黄疸指数(Π)26U。ECG示窦性心动过缓(43次/分),QT/QTC:560/506ms。脑电图中度
Male patient, 28 years old, farmer. Intermittent convulsions associated with disturbance of consciousness 2 months, systemic erythema and fever 6 days in December 3, 1994 admission. In the past 2 months, there was no incentive for patients to have generalized convulsions associated with disturbance of consciousness 5 times, each lasting 3 to 5 minutes after remission. Local treatment with Chinese medicine invalid, change service phenytoin sodium 1.2g / d, 2 weeks after symptom control. Nearly a week patients with generalized erythema, oral erosion with fever and admission. Examination: T 36.5 ℃, P 40 beats / min, R 20 beats / min, BP 11 / 7kPa (82.5 / 52.5mmHg), acute sickness, confusion, dysarthria, pupillary light reflex, yellow sclera, oral Mucosa scattered erosion, a slight resistance of the neck, generalized redness of systemic skin erythema, some fusion, the pressure of the fade. Breath sounds clear lungs, heart is not big, heart rate 40 beats / min, law Qi, no noise. Under the edge of the liver ribs 3cm, tenderness, spleen is not large, ascites sign negative. Urine: protein (++), RBC 4 ~ 8 / HP; BUN 8.9mmol / L, GPT 200U, creatine phosphokinase (CPK) 300U / L, jaundice index (UI) 26U. ECG showed sinus bradycardia (43 beats / min), QT / QTC: 560 / 506ms. EEG moderate