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患者女,42岁。自少年起下水田劳动,初起双膝关节痛,轻微红肿,继而波及肘、肩关节,与受凉、阴雨天有关,曾拟诊为“风湿性关节炎”。1971年起每于劳累时感心悸气短,且渐加重,伴有饭量增加、腹泻、消瘦等。当时未予诊治。1982年心悸气短加重,不能平卧,双下肢浮肿,尿少,曾先后多次在当地医院按“风心病、心衰”治疗,其效不佳。于1983年去外地求治,诊为“风心病、甲状腺机能亢进(简称甲亢)”,治疗1个月,症状有所缓解后出院,未继续治疗甲亢。于同年底因感冒后上述症状复发加重,伴有紫绀,急诊入我院。入院检查。T38.5C, P170/分,R28/分 BP
Female patient, 42 years old. Since juveniles started to work in paddy fields, they initially developed knee pain with slight swelling and then spread to elbows and shoulder joints. They were associated with cold and rainy days and had been accused of “rheumatoid arthritis.” Since 1971, each tired when feeling palpitations shortness of breath, and gradually heavier, accompanied by increased appetite, diarrhea, weight loss and so on. At that time, no diagnosis and treatment. 1982 palpitations increased shortness of breath, not supine, lower extremity edema, oliguria, has repeatedly in the local hospital according to “rheumatic heart disease, heart failure” treatment, its effectiveness is not good. In 1983 to seek treatment in the field, diagnosed as “rheumatic heart disease, hyperthyroidism (referred to as hyperthyroidism)” for 1 month, the symptoms were relieved after discharge, did not continue to treat hyperthyroidism. At the end of the same year due to a recurrence of the above-mentioned symptoms of influenza aggravated, accompanied by cyanosis, emergency into our hospital. Admission examination. T38.5C, P170 / min, R28 / min BP