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实习医师 本例患儿男性,8岁,15天前发热、咳嗽、流涕。用青霉素治疗3天后热退,5天症状消失。1周来觉心慌、胸闷,心电图示频发室性早博,于1992年9月21日入院。发育营养好,体温36.8℃,呼吸20次/min,血压11/2kPa。咽不红、颈软。心音低纯,有Ⅱ级柔软杂音,心率106次/min,有频发早博,8～10次/min。双肺听诊无异常。肝脾未扪及。无病理反射。化验检查:Hb150g/L,RBC4.2×10~(12)/L,WBC总数6.7×10~9/L,中性68％,淋巴31％,酸性1％。心肌酶谱检查:CK287U/L,CK-MB36U/L,LDH123U/J,LDH同功酶艹、卅、+、+、+,αHBDH260U/L,AST27U/L。血沉3mm/h,ASO400U。胸片无异常。心电图:窦性心律,频发配对性室性早搏,有时呈二联律。心室晚电位无异常。动态心电图,最快168次/min。发生时间13:14,上楼时
The intern was male, 8 years old, 15 days old and had cough and runny nose. 3 days after treatment with penicillin heat back, 5 days symptoms disappear. 1 week to feel palpitant, chest tightness, ECG frequent ventricular premature beats, in 1992 September 21 admission. Good development and nutrition, body temperature 36.8 ℃, breathing 20 times / min, blood pressure 11 / 2kPa. Pharynx red, neck soft. Low heart sound, there are grade Ⅱ soft murmur, heart rate 106 beats / min, frequent premature Bo, 8 to 10 beats / min. No abnormal lung auscultation. Liver and spleen not palpable. No pathological reflex. Laboratory tests: Hb150g / L, RBC4.2 × 10-12 / L, the total number of WBC 6.7 × 10 ~ 9 / L, 68% neutral, lymphatic 31%, acid 1%. Myocardial enzymes: CK287U / L, CK-MB36U / L, LDH123U / J, LDH isozyme 艹, 卅, +, +, +, αHBDH260U / L, AST27U / L. ESR 3mm / h, ASO400U. No abnormal chest X-ray. Electrocardiogram: sinus rhythm, frequent premature ventricular contractions, and sometimes showed a couplet law. Ventricular late potential no abnormalities. Holter, the fastest 168 times / min. Occurrence time 13:14, upstairs