Probably a fan on the way out. as the fans get older, the bearings wear down and they start making buzzing and rattling noises; eventually the fan will seize altogether.
While it is possible to replace a PSU fan, you're better off just to replace the PSU itself. There's some dangerous stuff in there and I really don't recommend opening it up unless you're able to identify what can hurt you and know how to handle it safely.
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I wake up in the morning more tired than before I slept
I get through cryin' and I'm sadder than before I wept
I get through thinkin' now, and the thoughts have left my head
I get through speakin' and I can't remember, not a word that I said
- Ben Harper, Show Me A Little Shame
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