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ARDS病因复杂,由多发性肌炎并发者罕见.兹将我科遇到的一例报告如下:患者女性(168545)47岁,干部.二个月来双膝、双肩、上臂肌肉酸痛、僵硬感,双眼睑浮肿.外院曾查类风湿因子阳性.于1984年12月10日以“类风湿性关节炎”入院.查体:心率106次/分,律整,无杂音.肺叩清、无罗音.呼吸28次/分,体温36.5℃,四肢关节无红肿.血沉32mm/h,血白细胞9,500/mm~3,中性82%.胸片示双下肺纹理模糊,杂有小斑片状阴影.予青霉素、链霉素及阿斯匹林治疗,入院第八天突然发现呼吸急促、呼吸达50～60次/分,明显紫绀,烦燥不安,双肺弥漫性湿罗音.吸入高浓度氧症状不能缓解.血气分析:pH7.506,PaCO_229.5.PaO_2 25,HCO_3~-23,BE2.1,SaO_245.5%.予持续面罩高浓度吸氧(80%左右)并用大量肾上腺皮质激素(下称激素.前三天氟美松160mg/日,6天后逐渐停用)及抗菌素,病情渐好转.第三天中心供氧站发生短暂
ARDS complicated etiology, complicated by polymyositis who are rare.Will I encounter a case report is as follows: Female patients (168545) 47 years old, cadres. Two months to knees, shoulders, upper arm muscle ache, stiffness, Double eyelid edema. Outside the hospital had checked rheumatoid factor positive .In December 10, 1984 to “rheumatoid arthritis” admission .Check the body: the heart rate of 106 beats / min, the whole law, no noise .Pulmonary clear, no Luo Sound breathing 28 beats / min, body temperature 36.5 ℃, limbs and joints without swelling, erythrocyte sedimentation rate 32mm / h, white blood cells 9,500 / mm ~ 3, neutral 82% Shadows. To penicillin, streptomycin and aspirin treatment, suddenly found on the eighth day of admission, shortness of breath, breathing up to 50 to 60 beats / min, obviously cyanosis, irritability, diffuse wet lung rales. Concentration of oxygen symptoms can not be alleviated .Analysis of blood gas: pH7.506, PaCO_229.5.PaO_2 25, HCO_3 ~ -23, BE2.1, SaO_245.5%. To mask high concentrations of oxygen (about 80%) and a large number of adrenal cortex Hormones (hereinafter referred to as hormones .From the first three days of dexamethasone 160mg / day, gradually deactivated after 6 days) and antibiotics, the disease gradually improved. The third day central oxygen station short-lived