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患者女,63岁。十余年前出现多关节肿痛,主要累及双手多个掌指及指间关节、双腕关节、双膝关节,伴晨僵,每日持续1 h以上;院外及本院门诊多次查红细胞沉降率及类风湿因子升高,诊断为类风湿关节炎(rheumatoid arthritis,RA),治疗不详,病情控制差,逐步出现双手多个指间关节变形。1年前患者出现心悸、乏力,活动后心累气促,当地查血红蛋白<50 g/L,经输血等
Female patient, 63 years old. More than ten years ago there were multiple joint swelling and pain, mainly involving both hands more than one metacarpophalangeal and interphalangeal joints, wrist, knees, with morning stiffness, lasting more than 1 h daily; hospital and outpatient check multiple red blood cells Settling rate and rheumatoid factor increased, the diagnosis of rheumatoid arthritis (rheumatoid arthritis, RA), the treatment is unknown, poor disease control, and gradually multi-finger two-hand joint deformation. 1 year ago, patients with heart palpitations, fatigue, heart and shortness of breath after the event, the local hemoglobin check <50 g / L, transfusion, etc.