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患者,女,56岁,教师。以发作性意识障碍7年,加重伴咳嗽半年入院。7年前无明显诱因出现发作性清晨昏睡,呼之方醒,醒后言语错乱,举止异常,伴头晕;如睡前加餐,症状可减轻。曾因昏迷于外院急诊测血糖1.2mmol/L。3年前就诊于某医院,测FPG 2.3 mmol/L,2hPG18.8mmol/L,胰岛素高,尿蛋白2+,诊断为胰岛β细胞瘤,患者不接受手术探查建议,自行出院。半年前,无明显诱因出现阵发性刺激性于咳、气短,于外院诊治,诊断为:(1)双侧漏出性胸腔积液;(2)胰岛细胞瘤;(3)2型糖尿病,糖尿病肾病;(4)原发性甲状腺
Patient, female, 56 years old, teacher. To episodic disturbance of consciousness for 7 years, increased with cough six months admitted. 7 years ago, there was no obvious incentive for onset of early morning drowsiness, wake-up call, wake up after the verbal disorder, abnormal behavior, with dizziness; such as snacks before going to bed, the symptoms can be reduced. Had coma in the hospital emergency blood glucose 1.2mmol / L. 3 years ago visited a hospital, measured FPG 2.3 mmol / L, 2hPG18.8mmol / L, high insulin, urinary protein 2+, the diagnosis of islet β-cell tumors, the patient does not accept the surgical exploration recommendations, discharge on their own. Six months ago, no obvious incentive for paroxysmal irritation in cough, shortness of breath, diagnosis and treatment in the hospital, diagnosed as: (1) bilateral leakage of pleural effusion; (2) islet cell tumor; (3) type 2 diabetes mellitus Nephropathy; (4) Primary thyroid