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患者:女性、67岁、退休工人、主因、周身无力、胸闷、憋气入院。自入院前七个月起出现颈,腰部肌肉无力,抬头困难,但无四肢活动性障碍。且两次出现体温升高,无头痛、咽痛,咳嗽等症状。入院前六个月起出现双下肢无力,行走困难,但可以从事一般劳动。入院前四个月起上述症状逐渐加重①不能直立行走,②伴有胸闷、憋气。③心肌三酶均明显升高。病人自发病以来无皮肤红斑,皮疹、结节、光敏现象及关节肿痛。发病前无外伤史。查体:BP130/80mmHg,神情合作、平卧位。慢性病容,皮肤巩膜无黄染。表浅淋巴结未触及,关节无红肿。双侧瞳孔等大、等圆,对光反射正常。双肺未闻干、湿罗音。心界不大,心脏各瓣膜未闻
Patients: Female, 67 years old, retired worker, main cause, whole body weakness, chest tightness, suffocation. Seven months after admission, neck and lumbar muscular weaknesses appeared, difficulties in raising the head, but no active limbs disorder. And twice the body temperature, no headache, sore throat, cough and other symptoms. Six months before admission, both lower extremities are weak and have difficulty walking, but can work in general. Four months before admission, the above symptoms gradually aggravate ① can not stand upright, ② accompanied by chest tightness, suffocation. ③ myocardial enzymes were significantly increased. Since the onset of patients with no skin erythema, rash, nodules, photosensitive phenomenon and joint swelling and pain. No history of trauma before onset. Examination: BP130 / 80mmHg, look and cooperation, supine position. Chronic disease, skin sclera without yellow dye. Superficial lymph nodes not touched, joint swelling. Pupils and other bilateral large, round, light reflex normal. The lungs did not smell dry, moist rales. Heart is small, the heart of the valve did not smell