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肺心病急性加重期的主要临床表现为呼吸衰竭和心力衰竭,加重的原因多为呼吸道感染。肝瘀血和缺氧均可引起肝功能改变,已为临床工作者所熟知,但肝功能方面的改变多数是轻微的,可有轻度黄疸,血总胆红素很少超过30μmol/L,转氨酶升高亦多不显著,但也确有少数肺心病患者急性加重期出现明显黄疸与转氨酶升高,临床上与急性肝炎难于区别。本文报告2例肺心病急性加重期出现类似肝炎征象,并就其发病机理,鉴别诊断及临床意义进行讨论。例1:男患,65岁.以慢性咳嗽、咳痰30余年,心悸气短,反复浮肿8年,气喘、浮肿加重,不能平卧1月而入院。
Cor Pulmonale acute exacerbation of the main clinical manifestations of respiratory failure and heart failure, mostly due to increased respiratory tract infections. Liver stasis and hypoxia can cause changes in liver function, has been well-known to clinicians, but most of the changes in liver function is mild, may have mild jaundice, blood total bilirubin rarely exceed 30μmol / L, Aminotransferase is also not significantly increased, but it does have a small number of patients with acute pulmonary exacerbation of jaundice and elevated transaminases, clinically difficult to distinguish with acute hepatitis. This article reports 2 cases of acute exacerbation of pulmonary heart disease appear similar symptoms of hepatitis, and its pathogenesis, differential diagnosis and clinical significance are discussed. Example 1: male patient, aged 65. To chronic cough, sputum for more than 30 years, palpitations shortness of breath, repeated edema for 8 years, asthma, edema aggravating, can not lie down and admitted to hospital in January.