1　临床资料患者 :男 ,43岁。因咳嗽 1个月余伴活动后气促半月以“风湿性心脏瓣膜病 ,二尖瓣狭窄并关闭不全”收入院。既往无心脏病病史。体检 :体温 37.3℃ ,脉搏 110次 / min,呼吸 2 0次 / min,血压 15 0 / 90 mm Hg(1mm Hg=0 .133k Pa) ,全身浅表淋巴结均未触及 ,无发绀 ,颈 1 Clinical data: Male, 43 years old. Due to coughing for more than 1 month after accompanied by activities and shortness of breath for half a month to “rheumatic heart valvular disease, mitral stenosis and insufficiency” income of the hospital. No previous history of heart disease. Physical examination: body temperature 37.3°C, pulse 110 beats/min, breathing 20 beats/min, blood pressure 15 0 / 90 mm Hg (1 mm Hg = 0.133 k Pa), no superficial lymph nodes in the body, no cyanosis, neck