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黄某,女,18岁,以发作性头昏,上肢无力3年余,视力减退8个月之主诉入院。3年前无诱因出现头昏,眼前发黑,劳累时双臂无力上举,近来梳头亦感无力,1年前曾晕倒两次,意识清楚,无抽搐或口吐白沫。8个月前左眼视力逐渐减退,继而发红,疼痛,1月后右眼亦红痛,视力急剧下降。患病后记忆力明显减退。在当地医院应用激素,血管扩张药及中药,均未显效。查体:T36℃,P96次/分,BP 右上肢30/0,左上肢28/0,右下肢150/80,左下肢190/90mmHg。发育可,面色苍白,四肢冷,桡动脉触不到跳动,颈、颞动脉搏动弱。颈软,胸部对称,两肺呼吸音正常,心界不大,心尖部和肺动脉瓣区可闻及Ⅱ°sm,左右锁骨上窝可闻及收缩期血管杂音,心律齐,A_2=P_2,腹软,肝肋下刚及,脾不大,生理反射正常,病理反射未引出。
Hwang, female, 18 years old, with episodic dizziness, upper limb weakness more than 3 years, 8 months of vision loss in the main complaint admission. 3 years ago, no incentive to appear dizzy, black eyes, unable to exert his arms over exertion, recently comb hair feeling weak, fainted twice a year ago, a clear consciousness, no convulsions or vomit foam. 8 months ago, left eye vision gradually diminished, and then redness, pain, right eye after January also red pain, sharp decline in vision. After the illness significantly reduced memory. Hormone in the local hospital, vasodilators and traditional Chinese medicine, were not effective. Physical examination: T36 ℃, P96 beats / min, BP right upper limb 30/0, left upper limb 28/0, right lower limb 150/80, left lower limb 190/90 mmHg. Development, pale, cold limbs, radial artery touch can not beat, neck, temporal pulsation weak. Neck soft, chest symmetry, normal lung sounds, the heart is not big, apical and pulmonary valve area can be heard and Ⅱ ° sm, left and right supraclavicular fossa can be systolic and systolic murmur, Qi Qi, A_2 = P_2, abdominal Soft, rib ribs just, spleen is not large, normal physiological reflex, pathological reflex did not lead.