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男,40岁。自幼起常咳嗽、喀白色粘痰,伴气促,寒季发作较多。1981、1985及1986年2月均因咳嗽、气促、水肿而住院,被诊断为慢支炎、肺心病,经抗感染、利尿、强心等治疗好转、近半月来上述症状加重又住院。体查:体温37.8℃,脉率120次,呼吸24次,血压14.9/10.4kPa;发育、营养欠佳,杵状指,唇紫绀,颈静脉怒张;胸廓桶状,叩诊过清音,双肺有哮鸣音,心界稍向左扩大,心率120次,律齐,心尖区有3/6级收缩期吹风性杂音,肝右肋下可扪及,腹有移动性浊音;下肢凹陷性水肿。实验室常规、生化、肝功能检查均正常。心电图示窦律过速、肺型P波伴左房高电压、右室肥厚、不完
Male, 40 years old. Since childhood cough, cough sticky phlegm, with shortness of breath, cold seizures more. 1981, 1985 and February 1986 were due to cough, shortness of breath, edema and hospitalization, were diagnosed as chronic myositis, pulmonary heart disease, anti-infective, diuretic, cardiac and other treatment improved in the past half months the above symptoms and hospitalization. Physical examination: body temperature 37.8 ℃, pulse rate 120 times, breathing 24 times, blood pressure 14.9 / 10.4kPa; development, poor nutrition, clubbing, lip cyanosis, jugular vein engorgement; thoracic barrel, percussion over voiceless, A wheeze, the heart slightly to the left to expand the heart rate 120 times, law Qi, apical area 3/6 systolic hair blowing murmur, palpable liver right rib palpitations, abdominal dullness; lower limb pitting edema . Laboratory routine, biochemical, liver function tests were normal. ECG shows sinus rhythm, pulmonary P wave with left atrial high voltage, right ventricular hypertrophy, endless