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叶××,男,53岁。因咯血33天、肾功损害22天,于1987年5月15日由他院转入我院。患者以咯血为最早和主要症状,但多为痰中带血,伴胸闷和咽喉部异物感。无发热、胸痛等。病后3天住当地医院,疑为“肺结核、支气管扩张”,用青链霉素、异烟肼治疗无效。住院第8天,检查发现蛋白尿、镜下血尿、肌酐和尿素氮明显异常,并且进行性加剧。无腰痛、尿少、水肿等。此次病前一个月有受凉“感冒”史。1972年常患“痛风”。无患肺结核、肾炎史。体检:T36~2C,P96次/分,R 22次/分,BP17.3/11.9KPa。神志清楚,面色苍白,贫血貌。咽部充血,双肺呼吸音清晰,心脏正常,肝脾未触及,双肾区无叩击痛,下肢
Ye × ×, male, 53 years old. Due to hemoptysis 33 days, renal damage 22 days, on May 15, 1987 transferred from his hospital to our hospital. Patients with hemoptysis as the earliest and main symptoms, but mostly bloody sputum, with chest tightness and throat foreign body sensation. No fever, chest pain and so on. 3 days after the illness live in a local hospital, suspected “tuberculosis, bronchiectasis,” with penicillin, isoniazid ineffective. On the 8th day of hospitalization, proteinuria, microscopic hematuria, creatinine and urea nitrogen were found abnormally and insidiously progressed. No back pain, oliguria, edema and so on. One month before the illness, there was a cold “cold” history. Frequently suffering from “gout” in 1972. No history of tuberculosis, nephritis. Physical examination: T36 ~ 2C, P96 beats / min, R22 beats / min, BP17.3 / 11.9KPa. Conscious, pale, anemic appearance. Pharyngeal congestion, clear lung sounds, normal heart, liver and spleen not touched, no perineal area percussion pain, lower extremities