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病例,患者,男,42岁。因干咳、肌痛、盗汗和厌食4周伴体重减轻6kg入院。此前2周开始咳白痰、进行性气促,抗生素治疗无效。既往健康,每日吸烟15支。查体:体温37.7℃,安静时呼吸急促,中心紫绀伴杵状指。皿压正常,心率90次/分,右室可闻及奔马律,双肺可闻及粗糙呼吸音、高调哨笛音及细小捻发音。动脉血:PO_2 5.3kPa、PO_2 5.0kPa、SO_270％。血细胞计数、肌酐和电解质检查正常。肺功能:FEV_1 1.92,FCV 2.33(预值3.63和4.42)。胸部X线显示弥漫性肺浸润。由于迅速发展致肺纤维化,而予服泼尼松60mg/d。追问病史得知患者是位喷漆工,工作时穿太空防
Case, patient, male, 42 years old. Due to dry cough, myalgia, night sweats and anorexia 4 weeks with weight loss 6kg admission. Earlier 2 weeks cough white sputum, progressive shortness of breath, antibiotic treatment ineffective. Past health, smoking 15 cigarettes a day. Physical examination: body temperature 37.7 ℃, rapid breathing when quiet, central cyanosis with clubbing. Pan normal pressure, heart rate 90 beats / min, the right ventricle can be heard and galloping, lungs can smell rough breathing sounds, high-profile whistle sound and fine twist pronunciation. Arterial blood: PO_2 5.3kPa, PO_2 5.0kPa, SO_270%. Blood count, creatinine and electrolytes were normal. Pulmonary function: FEV_1 1.92, FCV 2.33 (predictions 3.63 and 4.42). Chest X-ray showed diffuse pulmonary infiltrates. Due to the rapid development of pulmonary fibrosis, and to take prednisone 60mg / d. Asked the patient history is that a painter, wearing space defense at work