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患者女,20岁.5个月前出现双下肢肿胀、变硬,渐累及双上肢、面部,伴局部皮温发凉或发热,关节痛,活动稍受限.在他院诊断为硬皮病,给予脉管炎片和维生素E治疗未见好转.近日发热,口干,心悸,气短,胸闷.于1990年4月30月住入我科治疗. 体格检查:T39.1℃,P120次/分,R24次/分,BP110/75mmHg.一般情况尚好,双肺呼吸音粗糙,心率120次/分,律整,可闻及第三心音,无心包摩擦音.皮肤科情况:颜面浮肿,坚实发亮,面颊部皮肤发硬,额纹消失,面具样脸,鼻尖似鹰嘴,张口困难,口距变窄.双手至肘、双足至膝部皮肤肿胀、变硬,手捏无皱褶,有触痛,肤色暗紫,皮温下降,雷诺氏征(+).指(趾)末节变细,
Patient female, 20 years old .5 months ago, both lower extremity swollen, harden, gradually involving both upper extremities, facial, with local skin temperature hair or fever, arthralgia, activities slightly limited in his hospital diagnosed as scleroderma , Given vasculitis tablets and vitamin E treatment did not improve recently fever, dry mouth, heart palpitations, shortness of breath, chest tightness in April 1990 admitted to our department for treatment. Physical examination: T39.1 ℃, P120 times / Points, R24 times / min, BP110 / 75mmHg. General situation is good, rough breathing sounds of the lungs, heart rate 120 beats / min, law, can be heard and the third heart sound, heartless package friction sound. Dermatology: facial edema, Bright, cheek skin hard, forehead pattern disappear, mask-like face, nose tip like olecranon, mouth opening difficulties, narrowing of the mouth .Hand to the elbow, both feet to the knee skin swelling, hardened, pinch no wrinkles, Tenderness, dark complexion, skin temperature drop, Raynaud’s sign (+). Finger (toe) distal thinning,