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患者女性,48岁。因间断发热、咳嗽伴进行性加重的呼吸困难1年入院。入院前曾在外院进行痰集菌检查20余次,纤支镜检查5次,未能确诊。胸片动态观察:病灶由左上肺小斑片影逐渐增多扩大累及右肺,出现大片高密度致密影。行抗感染抗结核治疗无效,体重下降15公斤。1987年11月和1988年2月经电镜检查和支气管灌洗液(BAL)过碘雪夫染色(PAS)后诊断为肺泡蛋白沉积症,转本院。体检:T37.9℃,R32次/分,P120次/分,BP12.3/9.33KPa。慢性重病容。鼻翼搧动。左侧胸廓呼吸运动减弱,语颤缩低叩诊稍浊,左下肺闻湿啰音穆?20次/分,P_2>
Patient female, 48 years old. Due to intermittent fever, cough with progressive aggravating dyspnea 1 year admission. Before admission to the hospital for sputum bacteria check more than 20 times, bronchoscopy 5 times, failed to diagnose. Dynamic observation of chest X-ray: Lesions gradually increased from the left upper lung patch enlargement involving the right lung, a large high-density dense shadow. Anti-TB anti-TB treatment ineffective, weight loss of 15 kg. In November 1987 and February 1988 by the electron microscopy and bronchial lavage fluid (BAL) after iodization of Schiff stain (PAS) diagnosis of pulmonary alveolar proteinosis, transferred to the hospital. Physical examination: T37.9 ℃, R32 beats / min, P120 beats / min, BP12.3 / 9.33KPa. Chronic severe illness. Nose flap. Left thoracic respiratory motion weakened, reduced fibrillation percussion slightly turbid, lower left lung smell wet rales Mu? 20 beats / min, P 2>