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例1.女,55岁。口干、眼泪减少6年,关节疼痛、低热2年,于1996年8月入院。T37.3℃,P84次/min,BP19/10kPa。口腔粘膜干燥,舌面干裂,四肢关节活动受限,左手食指肿胀。实验室检查:尿pH7.0,Hb74g/L,ESR85mm/h,血pH7.51,HCO_3~-29.2mmol/L,肝和肾功能正常。ASO(-),抗SSA抗体(+),抗SSB抗体(+);RF(+),IgG10.8g/L,IgA2.3g/L,IgM2.1g/L,C_30.76g/L,C_40.22g/L,CH_(50)160u。蛋白电泳:A567g/L,α_140g/L,α_290g/L,β136g/L,γ 202g/L。血β_2—MG 4359μg/L,尿β_2—MG 387.3μg/L。Schirmer泪液分泌试验:左8mm/5min,右6mm/5min。腮腺X线造影示左腮腺导管各处不均匀狭窄,24h后腺泡内仍残留造影剂。诊断:干燥综合征(PSS)合并类风湿性关节炎。
Example 1. Female, 55 years old. Dry mouth, tear reduction 6 years, joint pain, fever 2 years, admitted in August 1996. T37.3 ° C, P84 times / min, BP19 / 10 kPa. Oral mucosa dry, tongue surface chapped, limited limb movement, swelling of the left index finger. Laboratory tests: urine pH7.0, Hb74g / L, ESR85mm / h, blood pH7.51, HCO_3 ~ -29.2mmol / L, normal liver and kidney function. ASO (-), anti-SSA antibody (+), anti-SSB antibody (+); RF (+), IgG10.8 g / L, IgA2.3 g / L, IgM2.1 g / L, C_30.76 g / L, C_40. 22g / L, CH_ (50) 160u. Protein electrophoresis: A567g / L, α_140g / L, α_290g / L, β136g / L, γ 202g / L. Blood β_2-MG 4359μg / L, urinary β_2-MG 387.3μg / L. Schirmer tear secretion test: left 8mm / 5min, right 6mm / 5min. Parotid X-ray showed left parotid duct around the uneven stenosis, 24h after the remaining alveolar contrast medium. Diagnosis: Sjogren’s syndrome (PSS) with rheumatoid arthritis.