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一、诊断及鉴别诊断:本例主要特点:(1)中年,男性;(2)急性发病,起病前曾有劳累着凉;(3)有慢性咳嗽史和轻度肺气肿;(4)全心扩大并有全心衰竭的表现;(5)蛋白尿及轻度氮质血症。根据上述特点,应和以下几种主要疾病鉴别。1.肺心病:患者有10多年慢性咳嗽病史,并有20多年吸烟史,临床有轻度肺气肿表现,在当地医院曾诊为“肺心病”。因此,首先要考虑本病。但本例缺乏典型肺心病的体征,胸片、心电图和超声
First, the diagnosis and differential diagnosis: The main features of this case: (1) middle-aged, male; (2) acute onset, had a cold before onset; (3) have a history of chronic cough and mild emphysema; (4) ) Heart full expansion and heart failure performance; (5) proteinuria and mild azotemia. According to the above characteristics, should be identified with the following major diseases. 1. Cor Pulmonale: The patient has a history of more than 10 years of chronic cough and has a history of more than 20 years of smoking. The patient has mild emphysema and has been diagnosed as “pulmonary heart disease” in a local hospital. Therefore, we must first consider the disease. However, this example lacks the typical signs of pulmonary heart disease, chest X-ray, ECG and ultrasound