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患者男,23岁,因惧热、烦燥、心悸、消瘦3个月入院。查体:体温36.8℃,颜面赤红,双眼炯炯有神。口唇无发绀。咽无充血。甲状腺Ⅲ°肿大,双侧基本对称,质软,双上极可闻及粗糙血管杂音。心界叩诊不大,心率128次/min,心音增强,节律整齐,心尖区 Ⅱ/6级收缩期吹风样杂音。双手细颤明显。白细胞4.8×10~9/L。胸片未见异常。B超示两侧甲状腺弥漫性肿大。核素扫描提示甲状腺增大,3小时吸碘率4.7％,24小时为26.2％。查甲状腺功能rT_3、rT_4、FY_3、FT_4均明显高于正
Male patient, 23 years old, due to fear of heat, irritability, palpitations, weight loss 3 months admission. Physical examination: body temperature 36.8 ℃, red face, eyes sparkling. No cyanosis lips. Throat without congestion. Thyroid enlargement of Ⅲ °, the bilateral basic symmetry, soft, double on the very best and rough vascular murmur. Heart percussion is not, heart rate 128 beats / min, heart sound enhancement, rhythm, apex Ⅱ / 6 systolic hair-like murmur. Shocking both hands clearly. WBC 4.8 × 10 ~ 9 / L. No abnormal chest X-ray. B ultrasound showed diffuse enlargement of the thyroid on both sides. Radionuclide scan showed thyroid enlargement, iodine absorption rate of 4.7% in 3 hours and 26.2% in 24 hours. Check thyroid function rT_3, rT_4, FY_3, FT_4 were significantly higher than positive