患者女,29岁,农民。双膝、踝、腕关节肿胀、疼痛、活动受限伴指(趾)端逐渐增粗2年余,同时有间歇性腹痛、腹泻。腹泻时大便每日2～3次,为稀便。在院外治疗无效于1982年7月7日来我院。既往无咳喘病史。无家族史。体检:体温36.8℃,脉搏72次/分,血压94/60毫米汞柱。发育正常,表浅淋巴结不肿大。胸无畸形。两肺无罗音及哮鸣音。心界不扩大,心音正常,心律规则,无杂音。腹部平软,肝脾肋下未扪及,左下腹有轻压痛,无包块。双腕、膝、踝关节明显肿胀,有 Female patient, 29 years old, farmer. Knees, ankles, wrist swelling, pain, limited mobility with the finger (toe) end gradually thickening more than 2 years, at the same time there are intermittent abdominal pain, diarrhea. Diarrhea stool 2 or 3 times a day, for loose stools. Invalid treatment outside the hospital July 7, 1982 came to our hospital. No previous history of cough and asthma. No family history. Physical examination: body temperature 36.8 ℃, pulse 72 beats / min, blood pressure 94/60 mm Hg. Normal development, superficial lymph nodes are not swollen. No abnormality in the chest. Two lungs without rales and wheeze. Heart does not expand, normal heart sound, heart rate rules, no noise. Abdomen soft, liver and spleen ribs palpable, left lower quadrant tenderness, no mass. Double wrists, knees, ankle swelling, there