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患者刘××,女,67岁,因头晕、血压高20余年、夜间阵发性呼吸困难一周入院。查体:血压28/16kPa(210/120mmHg),心界略向左扩大,心率96次/分,律齐、未及杂音。两肺呼吸音清。腹平软。未闻及血管杂音。辅检:胸片示主动脉迂曲、增宽,心胸比率0.56,两肺野清晰。血WBC7700/mm~3、N74％,L26％,血K~+ 4.2mmol/L,Na~+ 146mmol/L,C1105mmol/L,BUN19mg％,诊断为高血压病。给予巯甲丙脯酸12.5mg tid,心痛定10mg tid,消心痛10mg tid,双氢克尿噻25mg tid,缓释钾1.0 tid。次日患者即出现剧咳,咳
Liu × ×, female, 67 years old, due to dizziness, high blood pressure more than 20 years, paroxysmal nocturnal dyspnea hospitalized a week. Physical examination: blood pressure 28 / 16kPa (210 / 120mmHg), the heart slightly to the left to expand, heart rate 96 beats / min, law Qi, and no noise. Breath sounds clear both lungs. Abdomen soft. No smell and vascular murmur. Auxiliary examination: chest aorta tortuous, widened, cardiothoracic ratio of 0.56, two lung fields clear. Blood WBC7700 / mm ~ 3, N74%, L26%, blood K ~ + 4.2mmol / L, Na ~ + 146mmol / L, C1105mmol / L, BUN19mg%, diagnosis of hypertension. Given captopril 12.5mg tid, nifedipine 10mg tid, nocturnal pain 10mg tid, hydrochlorothiazide 25mg tid, sustained release of potassium 1.0 tid. The next day the patient showed severe cough and cough