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1 病例报告例1:男,55岁,因咳嗽、咳痰带血、发热伴左胸痛1月余收入院.既往患高血压病.查体:T38.5℃,左下肺叩诊呈浊音,语颤减弱,呼吸音减弱.X线诊断:左肺结核并胸膜炎.检验胸水:黄浊,比重1.029,蛋白75.5g/L,红细胞0.8×10~9/L,白细胞0.36×1O~9/L,中性0.20,淋巴0.37,嗜酸0.43,血沉21mm/h.经抗结核及对症治疗,1月后胸水基本吸收,好转出院.在家规律抗结核治疗.30天后上述症状复发,胸水增多.检验胸水:混浊,比重1.023,蛋白54.9g/L,红细胞1.4×10~9/L,白细胞2.1×10~9/L,嗜酸性粒细胞占分类比例增高为0.82,而末梢血液中白细胞7.8×10~9/L,中性0.72,淋巴0.27,嗜酸0.01,血沉58mm/L,继续抗结核及抽胸水治疗,症状减轻,胸水量减少,服药半年,未再复发,随访1年,现无任何症状,胸片示左下胸膜增厚,无积液.最后诊断:左肺结核并嗜酸性粒细胞增多性胸膜炎.
1 case report Example 1: Male, 55 years old, due to cough, sputum bloody fever with left chest pain more than 1 month admission to hospital .Previous hypertension: Physical examination: T38.5 ℃, left lower lung percussion was voiced, language X-ray diagnosis of left lung tuberculosis and pleurisy. Examination of pleural effusion: yellow turbidity, specific gravity 1.029, protein 75.5g / L, red blood cells 0.8 × 10 ~ 9 / L, white blood cells 0.36 × 10 ~ 9 / L, Sexual 0.20, lymphatic 0.37, eosin 0.43, erythrocyte sedimentation rate 21mm / h. After anti-tuberculosis and symptomatic treatment, after January basic absorption of pleural effusion, improved discharged. At home regular anti-TB treatment .30 days after the recurrence of the above symptoms, pleural effusion. Turbidity, the specific gravity of 1.023, protein 54.9g / L, erythrocyte 1.4 × 10 ~ 9 / L, white blood cells 2.1 × 10 ~ 9 / L, eosinophilic accounting for the proportion of classification increased to 0.82, while the peripheral blood leukocytes 7.8 × 10 ~ 9 / L, neutral 0.72, lymph 0.27, eosinophil 0.01, erythrocyte sedimentation rate 58mm / L, continued anti-tuberculosis and pleural effusion therapy, symptoms, hydrothorax decreased, taking six months, no recurrence, Chest radiograph showed left lower pleural thickening, no effusion .Final diagnosis: left pulmonary tuberculosis and eosinophilic pleurisy.