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病例:男,57岁。因进行性呼吸困难1个月,在外院考虑急性支气管炎住院,予中药及平喘药治疗无效,症状逐渐加重。查体:体温38.5,脉搏105,喘息状态,不能平卧,口唇中度紫绀,两肺中部及肺底可闻表浅、细小、密集的高调爆裂性啰音及中等湿啰音。白细胞分类计数12.8×10~9/L、多核0.82、淋巴0.14:ESR36mm/lh,lgG32.76mg/ml、血气分析:PaO_27.73kPa、pH7.447、Pa-CO_24.53kPa。经皮肺活检见大量中性白细胞及肺巨噬细胞,经纤支镜活检见中性及巨噬细胞为主。胸部CT检查诊断为肺间质性肺泡炎并感染。多次痰检未查到抗
Case: Male, 57 years old. Due to progressive dyspnea for 1 month, hospitalized for acute bronchitis in the outpatient setting, treatment with traditional Chinese medicine and antiasthmatic drugs is ineffective, and symptoms gradually worsen. Physical examination: body temperature 38.5, pulse 105, wheezing, can not lie down, lips moderate cyanosis, both lungs central and lung bottom can be heard superficial, small, dense high-profile burst rales and wet rales. Leukocyte count 12.8 × 10 ~ 9 / L, multi-core 0.82, lymph 0.14: ESR36mm / lh, lgG32.76mg / ml, blood gas analysis: PaO_27.73kPa, pH7.447, Pa-CO_24.53kPa. Percutaneous lung biopsy to see a large number of neutrophils and lung macrophages, fibroids biopsy see neutral and macrophages. Chest CT examination diagnosed as pulmonary interstitial alveolitis and infection. Multiple sputum tests found no resistance