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患者女,72岁,因反复咯血5个月加重2天急诊.既往有“支气管扩张、陈旧性肺结核”,否认冠心病史.查体:血压17.5/12kPa,神清,贫血貌,双肺散在干鸣,右下肺少许湿罗音,心界不大,心率92次/分,律齐,各瓣膜区未闻及病理性杂音,腹部未见阳性体征.血色素99g/L,白细胞9×10~9/L,胸片示两下肺少许炎症、陈旧性肺结核.心电图正常.观察期间给予止血敏、氧哌嗪青霉素等治疗,后加用垂体后叶素10μ入100ml液中以1.1μ/分速度静点,12小时后改为30μ入500ml液中静点,每日一次.3天后咯血停止,但出现胸闷、心前区不适,心率110次/分,律齐,心电图示V_1～V_4的ST段抬高2.5～3.5mm伴T波倒置,V_1～V_3呈QS型,V_4～V_6呈qR型,心肌酶谱:CK453μ/L、GOT83μ/L、LDH511μ/L、HBDH317μ/L、CKmm_3/CKmm_1>1.0,诊断为
Patient female, 72 years old, due to repeated hemoptysis 5 months exacerbated 2 days emergency .Previously, “bronchiectasis, old tuberculosis”, denied the history of coronary heart disease .Check the body: blood pressure 17.5 / 12kPa, Shen Qing, anemia appearance, Dry Ming, right lower lung a little wet rales, heart is not big, heart rate 92 beats / min, law Qi, the valve area is not known and pathological murmur, no positive signs of the abdomen .Hemoglobin 99g / L, white blood cells 9 × 10 ~ 9 / L, chest X-ray showed a little inflammation of the lungs, old tuberculosis .Electrocardiogram normal .Hemostasis during the observation, piperacillin and other treatment, after the addition of pituitrin 10μ into 100ml liquid to 1.1μ / Divide the speed of static point, 12 hours later changed to 30μ into 500ml liquid static point, once daily .3 days after the hemoptysis stopped, but there chest tightness, precordial discomfort, heart rate 110 beats / min, law Qi, ECG V_1 ~ V_4 The ST segment elevation was 2.5 ~ 3.5mm with T wave inversion. V_1 ~ V_3 was QS type and V_4 ~ V_6 was qR type. The myocardial enzymes were CK453μL, GOT83μL, LDH511μL, HBDH317μL, CKmm_3 / CKmm_1> 1.0, diagnosed as