论文部分内容阅读
患者,女性,18岁.因全身关节肌肉酸痛3月余,发热、伴咳嗽一周入院.查体:T38.6℃,P100次/分,R20次/分,Bp12/8kPa.面部蝶形红斑,双肺可闻及干湿罗音,心界不大,心音低钝,肝肋下1cm、质软,双肾区叩击痛,双手有雷诺氏现象,神经系统无异常.实验室检查:尿蛋白(++)、红细胞、白细胞、透明管型及颗粒管型均为少许;血ds-DNA抗体41.27%、ANA抗体阳性,血沉47mm/h;血白蛋白33g/L、白蛋白/球蛋白为0.9/l、ALT72U.胸片示两肺下野弥漫性浸润性阴影.确诊为系统性红斑狼疮(SLE).入院后第5天出现进固体食物有梗阻感,饮水从鼻中呛出,继而说话语言不清、声嘶;无强哭及强笑.查体:肝肋下3cm;鼻音、咽反射消失,软腭提升无力,悬雍垂居中,伸舌居中,
Patients, females, aged 18. Due to systemic muscle soreness more than 3 months, fever, with cough and hospitalization a week.Check the body: T38.6 ℃, P100 beats / min, R20 beats / min, Bp12 / 8kPa. Facial butterfly erythema, Lungs can be heard and dry and wet rales, heart, blunt heart, liver ribs 1cm, soft, renal percussion pain, both hands have Raynaud’s phenomenon, the nervous system no abnormal laboratory tests: urine Protein (++), erythrocytes, leukocytes, clear tube and granular tube were a little; blood ds-DNA antibody 41.27%, ANA antibody positive, erythrocyte sedimentation rate 47mm / h; serum albumin 33g / L, albumin / globulin Was 0.9 / l, ALT72U.Diagnostic chest X-ray showed diffuse diffuse shadow of the two lungs .System diagnosed with systemic lupus erythematosus (SLE) .5 days after admission into the solid food into the obstruction, drinking water from the nose choke, and then Speaking language is unclear, hoarseness; no strong cry and strong laugh. Physical examination: Liver ribs 3cm; nasal, pharyngeal reflex disappeared, soft palate to enhance weakness, middle of the uvula,