1病例患者,男,43岁。2个月前无明显诱因出现胸闷气短,活动加重,休息略缓解,偶有腹胀,无腹痛及心前区疼痛。偶有咳嗽,少量白痰,偶发热,T37.5℃左右,无寒战。当地按冠心病予硝酸甘油,银杏叶等药物治疗,胸闷气短略缓解。3d前出现呼吸困难,不能平卧,伴恶心呕吐,尿量较平素减少。无咳嗽、咳痰及发 1 patient, male, 43 years old. 2 months ago, there was no obvious incentive chest tightness, shortness of breath, aggravate, slightly relieve the rest, occasional bloating, no abdominal pain and precordial pain. Occasional cough, a small amount of white sputum, even fever, T37.5 ℃ or so, no chills. Local coronary heart disease to nitroglycerin, Ginkgo biloba and other drug treatment, chest tightness gas short-term relief. 3d before breathing difficulties, can not lie down, with nausea and vomiting, urine output is less than usual. No cough, sputum and hair