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病例报告 [例1]女,20岁,农民,住院号184570。1982年5月10日入院。入院前一周开始发热、头晕与乏力,至三天前发热达40℃,并出现持续性胸闷伴压迫感,一天前晕厥五次。入院时体检:体温37.5℃,呼吸24次/min,血压110/70mmHg,神志清楚,心界向左稍扩大,心率88次/min,律齐,心尖区有Ⅰ级吹风样收缩期杂音,心音强弱不等,第一心音分裂。血沉17mm/h(Cutler法),抗“0”<333u,粘蛋白138mg/dl(Winzler法),血清GPK150u,SGOT53u,LDH845u,血培养阴性。胸片示心影饱满。心电图示Ⅲ度房室传导阻滞,V_1～V_3导联ST段呈弓背形向上抬高14～15mm。入院前后静脉滴注异丙肾上腺素,并于5月12日经股静脉插入双极起搏导管,作临时性按需型右心室心内膜下人工心脏起搏,每日给予琥珀酰氢化考的松。5月16日心电图示完全性右束支传导阻滞,左前分支传导阻滞及Ⅰ度房室传导阻滞,V_1～V_3导联均为QR波形,ST段仍抬高。5月18日为完全性右束支及Ⅰ度房室传导阻滞,5月21日ST段抬高好转,5月30日ST段抬高消失。患者病情逐日好转,至6月14日仅有
Case Report [Example 1] Female, 20 years old, farmer, hospital number 184570. May 10, 1982 admitted. One week before admission, fever, dizziness and fatigue started to reach 40 ° C three days ago. Persistent chest distress was accompanied by a sense of pressure and fainting five times a day. Physical examination on admission: body temperature 37.5 ℃, breathing 24 times / min, blood pressure 110 / 70mmHg, clear mind, the heart slightly expanded to the left, the heart rate 88 beats / min, law Qi, apical area Ⅰ grade hair systolic murmur, Strength range, the first heart sound split. ESR 17mm / h (Cutler method), anti “0” <333u, mucin 138mg / dl (Winzler method), serum GPK150u, SGOT53u, LDH845u, blood culture negative. Chest X-ray shows fullness. ECG showed a third degree atrioventricular block, ST segment V_1 ~ V_3 was bow upward raised 14 ~ 15mm. Intravenous infusion of isoproterenol before and after admission, and on May 12 through the femoral vein bipolar pacing catheter for temporary on-demand right ventricular subendocardial artificial cardiac pacing, daily administration of succinyl hydrogenation test Loose May 16 electrocardiogram showed complete right bundle branch block, left anterior branch block and I degree atrioventricular block, V_1 ~ V_3 leads were QR waveform, ST segment is still elevated. May 18 for the complete right bundle branch and Ⅰ degree atrioventricular block, ST segment elevation improved on May 21, May 30 ST segment elevation disappeared. The patient’s condition improved day by day, to June 14 only