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1临床资料患者,女,65岁,6年前开始每年秋冬季反复咳嗽、咳痰,每次咳嗽持续时间2～3个月。近日因着凉,出现咳嗽、咳痰,气短,呼吸困难,于2012年8月5日来本院中西医结合科就诊。体检:T 36.8℃,P 100次/min,R 25次/min,BP110/75 mmHg,听诊:两肺呼吸音减弱,呼气相延长,平静呼吸时可闻干性哕音,两肺底闻湿哕音;心音遥远,剑突部心音较清晰响亮。肺功能检查:1 s用力呼气容积与用力肺活量的比例(FEV_/FVC)为61%;FEV.占预计值50%,胸部X线检查:可见肺过度充气,肺容积增大,胸腔前后径增长,肋骨走向变平,肺野透亮度增高,横膈位置低平,心脏悬垂狭长,肺门血管纹理呈残根状,肺野外周血管纹理纤细稀少。诊断
1 Clinical data Patients, female, 65 years old, 6 years ago began to cough and sputum in autumn and winter every year, duration of each cough 2 to 3 months. Recently due to cold, cough, sputum, shortness of breath, difficulty breathing, on August 5, 2012 to our hospital Integrative Medicine clinic. Physical examination: T 36.8 ℃, P 100 beats / min, R 25 beats / min, BP110 / 75 mmHg, auscultation: both lungs breath sounds weakened, expiratory phase prolonged, calm breathing can be heard dry 哕 sound, Wet 哕 sound; distant heart sounds, more clear and loud xiphoid heart sounds. Pulmonary function tests: 1 second forced expiratory volume and forced vital capacity ratio (FEV_ / FVC) was 61%; FEV. Accounted for 50% of the expected value, chest X-ray examination: visible lung hyperinflation, increased lung volume, chest anteroposterior diameter Growth, rib to flatten, lung field through the brightness increased, diaphragm position low level, the heart drape slender, hilar vascular texture was residual root shape, lung field peripheral vascular thin slender. diagnosis