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1.病例介绍 患者,女,54岁,因干咳1月入院。前不久拔牙因局麻发生休克,1月前发生干咳,使用氟嗪酸600mg/d,干咳加剧,并有流泪,以后使用Cefioxime200mg/d,又出现上述症状,胸片示左上肺阴影。入院时检查,左上肺背部可闻湿性罗音、血沉,第1小时58mmH_2O,第2小时105mmH_2O,CRP2.9mg/dl,嗜酸细胞25％,IgE1200u/ml,PaO_2轻度降低,痰培养无致病菌生长,结核菌阴性。胸片示两肺有不对称的斑片状阴影。入院后停一切药物,分别进行利多卡因,阿托品,氧哌嗪青霉素和二甲胺四环素隔日皮内试验,20～30min后出现干咳,血压降低,胸部不适,末梢血嗜酸细胞增多。给予强的松龙治疗,又出现干咳、血压下降,胸部不适,发热,胸部阴影扩大至全肺野,左横膈
1. Case description Patients, female, 54 years old, admitted to hospital on dry cough in January. Not long ago, because of local anesthesia, hemorrhagic shock occurred in January, with the onset of dry cough 1 month ago, the use of flufenamic acid 600mg / d, increased dry cough, and tearing, after using Cefioxime200mg / d, and the above symptoms, chest X-ray showed the left upper shadow. Admission examination, the left upper lung back can smell wet rales, ESR, first hour 58mmH2O, the first two hours 105mmH2O, CRP2.9mg / dl, eosinophils 25%, IgE1200u / ml, PaO2 slightly lower, sputum culture without causing Bacteria growth, tuberculosis negative. Chest radiograph shows asymmetric patchy shadows on both lungs. All drugs were stopped after admission. Lidocaine, atropine, piperacillin and minocycicin were tested every other day. After 20-30 minutes, dry cough, hypotension, chest discomfort and peripheral blood eosinophilia were observed. Give prednisolone treatment, there dry cough, blood pressure, chest discomfort, fever, chest shadow extended to the whole lung field, the left diaphragm