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病历摘要患者男,36岁,因头昏,咯血3天于1984年1月30日入院。1980年2月起反复低热,关节痛,血沉增快,蛋白电泳γ球蛋白增高。以后相继发现双手无脉,平时经常感冒、咳嗽。入院前3～4个月反复痰中带血,伴疲乏,无力,盗汗,黑蒙。查体:双手桡动脉消失,双上肢血压测不清,两下肢血压140/80～90,双颈根部可闻及Ⅱ级以上血管杂音,三尖瓣区Ⅱ级以上收缩期杂音,白细胞10,500,血沉60mm,γ球蛋白27％,免疫球蛋白正常范围,免疫复合物阳性(PEG法),抗核抗体阴性,胸片示两肺支气管病变两肺门感染。入院后经皮质激素,免疫抑制剂,止血
Patient summary Male, 36 years old, dizzy, hemoptysis for 3 days in January 30, 1984 admission. Repeated fever since February 1980, joint pain, ESR faster, protein electrophoresis gamma globulin increased. After one after another have found no pulse, usually cold, cough. 3 to 4 months before admission bloody sputum repeatedly, with fatigue, weakness, night sweats, darkness. Physical examination: both hands radial artery disappeared, blood pressure was not measured in both upper extremities, two lower extremity blood pressure 140/80 ~ 90, two neck can be heard above the blood vessels and grade Ⅱ murmur, tricuspid valve area above grade Ⅱ systolic murmur, leukocytes 10,500, ESR 60mm, γ-globulin 27%, normal range of immunoglobulin, immunocomplex positive (PEG method), anti-nuclear antibody negative, chest X-ray showed bronchial lesions of both lungs infection. After admission corticosteroids, immunosuppressive agents, to stop bleeding