患者男,72岁。因关节疼痛加重,伴胸闷、气短、咳嗽1周于2008年3月10日就诊。自11年前开始出现双手近端指关节、掌指关节、双膝关节肿胀疼痛,晨僵约30min,当地医院诊断为类风湿关节炎,先后服用中西药物治疗,未用慢作用药及激素治疗,症状时好时坏,近3~4年逐渐出现双手变形。入院前1周,无诱因出现全身关节疼痛加重,影响行走, Male patient, 72 years old. Due to increased joint pain, with chest tightness, shortness of breath, cough for 1 week on March 10, 2008 treatment. Since 11 years ago began to appear near the hands of the proximal knuckles, metacarpophalangeal joint, double knee swelling and pain, morning stiffness about 30min, the local hospital diagnosed as rheumatoid arthritis, has taken Chinese and Western medicine treatment, not with slow-acting drugs and hormone therapy , When the symptoms of good and bad, nearly 3 to 4 years gradually deformed hands. One week before admission, there is no incentive to increase the body joint pain, affecting walking,