患者男,23岁,因四肢关节酸痛肿大,手足指趾末端增粗,呈杵状样改变,伴麻木不适一年余而入院。从1977年9月始,发现手足指趾末端增大,此后各关节常因天气变化而感酸痛,伴有局部红肿麻木感,但活动度尚可,同时又自感经常胸闷,呼吸不畅,常因劳累而感心跳气短,但休息片刻即好转。患者否认既往有任何疾病及风湿性关节炎病史。家庭人员身体均健康。检查:体温、脉搏、血压均在正常范围内,全身未见出血点,无黄染,腹股沟淋巴结如黄豆大小,无触痛,两肺听诊无异常,心律齐,心尖区可闻及Ⅱ级收缩期杂音及舒张期杂音。腹软,未触及包块,肝脾未及。四肢关节均有不同程度的增大,手足指趾末端 Male patient, 23 years old, because of joint swelling and pain in the limbs, hands and feet toe tip thickening, was clubbing-like changes, with numb discomfort for more than a year and hospitalization. From the beginning of September 1977, it was found that the ends of the fingers of the hand and foot increased, and then the joints were often sore due to the weather changes, accompanied by local swelling and numbness, but the activity was acceptable, but also often feel chest tightness, poor breathing, Often tired because of fatigue and shortness of breath, but a break that is better. Patients denied any previous history of disease and rheumatoid arthritis. Family members are in good health. Check: body temperature, pulse, blood pressure are within the normal range, the body no bleeding, no yellow dye, inguinal lymph nodes such as soy size, no tenderness, both lung auscultation no abnormalities, arrhythmia, apex area can be heard and Ⅱ grade contraction Period murmur and diastolic murmur. Abdominal soft, not touched mass, liver and spleen not yet. Limbs and joints have varying degrees of increase, hand and foot toe ends