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患者,女,7岁,因低热四肢活动障碍,吞咽困难,声音低弱20天。2月前,因游走性关节肿痛伴心律不齐先后数次诊断为“风湿性关节炎、心肌炎”,阿斯匹林治疗无效。查体:T37.2℃,P150次/分,R26次/分,BP110/60mmHg。神清,萎扉,颜面潮红,口腔粘膜充血,有多处溃疡,双肺有少许痰鸣,心律不齐,双上肢不能括举,肌力Ⅱ—Ⅲ级,双下肢Ⅱ级。均近端重于远端,腱反射消失,余无异常。辅助检查:除血沉55mm,补体C_375mg/dl,EKG示窦性心动过速,低电压、Tv_1—v_5倒置,有频繁的室早,呈二联律外,余三大常规、肝功能、类风湿因子、抗链“O”、C反应蛋白,胸片及结核菌素均无异常。入院印象:多发性
Patient, female, 7 years old, dyskinesia due to fever, extremities, swallowing difficulties, low and sound for 20 days. 2 months ago, due to migratory joint swelling and pain with arrhythmia has several times diagnosed as “rheumatoid arthritis, myocarditis,” aspirin treatment ineffective. Physical examination: T37.2 ℃, P150 beats / min, R26 beats / min, BP110 / 60mmHg. Shen Qing, Fei Fei, facial flushing, oral mucosal hyperemia, multiple ulcers, lungs have a little phlegm, arrhythmia, both upper extremities can not include, muscle strength Ⅱ-Ⅲ level, both lower extremity Ⅱ level. Were proximal to more distal, tendon reflex disappeared, I no abnormalities. Auxiliary examination: In addition to blood sediment 55mm, complement C_375mg / dl, EKG showed sinus tachycardia, low voltage, Tv_1-v_5 inversion, frequent premature ventricular contractions, the couplet law, the other three general rules, liver function, rheumatoid Factor, anti-chain “O”, C-reactive protein, chest X-ray and tuberculin were normal. Admission impression: multiple