患儿,女,10岁4个月。因咳嗽1月余入院。咳嗽为阵发性连声干咳,咳剧时有气急、面部及肢端青紫,间断发热。无胸痛、咯血、脓痰、盗汗等。抗生素治疗无效。体检:体温36.8℃,呼吸40次/分,体重23kg。神志清,精神萎靡,发育营养差,消瘦,面颊及口唇青紫,气促,未见皮疹皮出血点。两肺呼吸运动相等,右肺语颤增强,右肺叩浊,双肺呼吸音粗糙,未闻及干湿罗音。腹壁皮下脂肪约0.4cm,心、腹未见异常,四肢关节无红肿热痛,手足杵状指(趾),甲床青紫。胸片示见两侧胸廓对称,两肺野广泛分布的粗线网状 Children, women, 10 years and 4 months. More than 1 month due to cough hospitalization. Cough cough paroxysmal cough, cough drama when there is irritability, facial and extremities bruising, intermittent fever. No chest pain, hemoptysis, purulent sputum, night sweats and so on. Antibiotic treatment is invalid. Physical examination: body temperature 36.8 ℃, breathing 40 beats / min, weight 23kg. Consciousness, apathetic, poor nutrition, weight loss, cheeks and lips bruising, shortness of breath, no skin rash bleeding. Respiratory movement of both lungs equal, right lung tremor increased, right lung knock turbidity, lungs, breathing sounds rough, no smell and wet and dry rales. Abdominal wall subcutaneous fat about 0.4cm, heart, abdomen no abnormalities, limbs joint pain without swelling, hand, foot clubbing (toe), nail bed purple. Chest radiographs showed symmetrical thoracic on both sides, extensive reticular distribution of both lung fields