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特发性弥漫性肺间质纤维化症,是一种严重的呼吸系疾病。国内文献只有零星报道,系统尸体解剖报告更少。我们将最近遇到的1例尸解病例报告如下,供同道们参考。病历摘要:患者,女性,23岁。因反复咳嗽、气促1年,近1个月来症状加重,呼吸困难,不能平卧并伴胸痛入院。体检:神志清楚。呼吸较促,每分钟32次。双肺呼吸音清,仅在左肺底可闻少许小水泡音。血压90/60,心率96次,各瓣膜听诊区未闻杂音。实验室检查:红细胞510万,血红蛋白14.6g。白细胞18,600,其中中性白细胞89%,淋巴细胞8%,单核细胞3%。NPN22mg%,CO_2cp42.4Vol/100ml。类风湿试验阴性。抗核抗原阳性(间接荧光免疫法)。血液气体分析意见:代偿性呼吸性硷中毒,低氧血症。X线检查:双肺呈大量絮片状阴影。患者经给予抗生素及对症处理,症状未见改善,呼吸困难逐渐加重。临床诊断:双肺慢性感染。
Idiopathic diffuse pulmonary fibrosis, is a serious respiratory disease. Domestic literature only sporadic reports, the system autopsy report less. We have recently encountered a case of autopsy reported below, for the fellow reference. Medical record summary: Patient, female, 23 years old. Due to repeated cough, shortness of breath for 1 year, nearly 1 month to aggravate the symptoms, breathing difficulties, can not supine and chest pain admitted. Physical examination: conscious. Breathing more urgently, 32 times per minute. Respiratory sound clear lungs, only a small bubble in the left lung can smell a small sound. Blood pressure 90/60, heart rate 96 times, the valve auscultation area did not hear noise. Laboratory tests: 5.1 million red blood cells, hemoglobin 14.6g. 18,600 leukocytes, including 89% of neutrophils, 8% of lymphocytes and 3% of monocytes. NPN 22 mg%, CO 2 cp 42.4 Vol / 100 ml. Rheumatoid test negative. Anti-nuclear antigen positive (indirect fluorescence immunoassay). Analysis of blood gases: compensatory respiratory alkalosis, hypoxemia. X-ray examination: lungs were a large number of flaky shadows. Patients given antibiotics and symptomatic treatment, no improvement in symptoms, breathing difficulties gradually increased. Clinical diagnosis: chronic lung infection.