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咯血可能提示有严重的肺病,但其原因却往往难以发现。如Johnston氏等分析了324例咯血患者,除97例(30%)是由肺炎、慢性支气管炎和支气管扩张所致外,142例(44%)原因不明。作者在临床上发现几例咯血患者与阿斯匹林有关。例1 男,67岁。体检发现肺上野有肺结核所致的纤维样改变。主诉每年都咯血数次,痰中带鲜红色血丝。并注意到咯血与服用阿斯匹林有关,1年前停药后未再咯血。例2 女,57岁。曾因肺结核作过右侧胸廓成形术,5年前曾有过一次咯血,自述与上感有关。本次因重感冒咳嗽,口服“Bvecham’s粉”(一种含阿斯匹林的药)后痰中带鲜红色血丝4天,停药后未再咯血,随访无新生物生长。例3 男,13岁。几天内连续咯血两次,每次咯血2～3ml,呈暗红色。1周前因患感冒口服“Dispirin”(一种含阿斯匹林的药)12小时后出现咯血。
Hemoptysis may indicate serious lung disease, but the reasons are often difficult to find. 324 patients with hemoptysis, such as Johnston’s, analyzed 142 patients (44%) for unknown reasons, except 97 (30%) due to pneumonia, chronic bronchitis and bronchiectasis. The authors found several cases of hemoptysis in patients clinically relevant to aspirin. Example 1 male, 67 years old. Physical examination found that pulmonary UF have tuberculosis caused by fibrous changes. The main complaint of hemoptysis several times a year, sputum with bright red bloodshot eyes. He noted that hemoptysis was associated with taking aspirin, with no further hemoptysis after discontinuation 1 year ago. Example 2 female, 57 years old. Has done because of pulmonary tuberculosis right thoracoplasty, 5 years ago there had been a hemoptysis, readme and the sense of the flu. The cough caused by a cold, oral “Bvecham’s powder” (an aspirin-containing drug) sputum with bright red bloodshot eyes after 4 days, no longer hemoptysis after stopping, no new growth following the study. Example 3 male, 13 years old. A few days of continuous hemoptysis twice, each hemoptysis 2 ~ 3ml, dark red. Hemoptysis occurred 12 hours after oral administration of “Dispirin” (an aspirin-containing drug) for a cold a week ago.