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病历摘要:女性,20岁,因四肢关节肿痛7月,发热伴心悸,气短一周于1989年11月入院。患者于1989年4月无明显原因出现四肢关节痛伴发热,5月住院,诊断类风湿性关节炎,经抗风湿渤疗病情缓解后出院。8月病情反复再入院,检查发现面部蝶形红斑,诊断类风湿性关节炎和系统性红斑狼疮,给予相应治疗,病情缓解后出院。11月病情再次反复且伴有高热,心悸、呼吸困难而第三次入院。查体:T39℃,R28次/分,P110次/分,BP13.5/8kpa(100/60mmg),面容刻板,精神差,热病容,呼吸急促,不能平卧,颜面见蝶形红斑,张口困难,面部、双上肢、躯体部皮肤肿胀增厚,有硬感。右中下肺呼吸音低,心界向左
Medical record Summary: Female, 20 years old, due to joint swelling and pain in limbs in July, fever with palpitations, shortness of breath a week in November 1989 was admitted. Patients in April 1989 there was no obvious reason for joint pain with limbs fever, hospitalization in May, the diagnosis of rheumatoid arthritis, antirheumatic Bo treatment of patients discharged after discharge. In August the patient was repeatedly admitted to the hospital for examination and found facial butterfly erythema, diagnosis of rheumatoid arthritis and systemic lupus erythematosus, given the appropriate treatment, the disease was relieved and discharged. The disease was repeated again in November and accompanied by fever, palpitations, and difficulty breathing for the third time. Physical examination: T39 ℃, R28 times / min, P110 beats / min, BP13.5 / 8kpa (100 / 60mmg), face stereotypes, poor spirit, fever, shortness of breath, Difficulty, facial, upper extremity, body part of the skin swelling thick, hard sense. Right lower lung breath sounds low, left heart