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患者男性,18岁,住院号61262,于1993年12月20日因间断性双下肢关节疼痛7年,加重伴发热1周收入住院。曾于1986年、1988年、1990年三次因上症发作而住院,诊断为风湿热,经口服强的松治疗好转,并曾出现过结膜炎及口腔溃疡。查体:T 38℃,R 20min~(-1),P 96min~(-1),BP 13.3/8.0kPa。消瘦,心肺腹部检查未发现阳性体征,脊柱生理弯曲存在活动如常,双膝及右肘关节红肿,左骶髂关节活动受限。实验室检查:Hb 104g/L,WBC 7.6×10~9/L,N 77％,L 23％,PC 160×10~9/L,ESR 110mm/h,血IgG 27.6g/L,IgA1.52g/L,IgM 0.87g/L,C_3 1.59 g/L,CRP>20mg/L,RF阴性,抗“O”<1:500U,血蛋白电泳A 47.18％,α_1 9.49％,α_2 13.99％,β 10.39％,γ 21.98％,自身抗体检测阴性。胸片:右下肺野可见索条状阴影,边缘模糊,骶髂关节拍片(前后位):两侧骶髂关节面增白,模糊,密度增高,并见左
Male patient, 18 years old, hospital number 61262, on December 20, 1993 due to intermittent bilateral lower extremity joint pain for 7 years, increased fever with 1 week income hospitalization. Had in 1986, 1988, 1990, three episodes of illness due to hospitalization, diagnosis of rheumatic fever, oral prednisone improved, and there have been conjunctivitis and oral ulcers. Examination: T 38 ℃, R 20min ~ (-1), P 96min ~ (-1), BP 13.3 / 8.0kPa. Weight loss, cardiopulmonary abdominal examination found no positive signs, spinal curvature exists as usual activity, knees and the right elbow joint swelling, left sacral and iliac joint activity is limited. Laboratory tests: Hb 104g / L, WBC 7.6 × 10 ~ 9 / L, N 77%, L 23%, PC 160 × 10 ~ 9 / L, ESR 110mm / h, blood IgG 27.6g / L, IgA 1.52g / L, IgM 0.87g / L, C_3 1.59g / L, CRP> 20mg / L, RF negative, anti “O” <1: 500U, electrophoresis of blood protein A 47.18%, α_1 9.49%, α_2 13.99%, β 10.39 %, Γ 21.98%, autoantibodies negative. Chest radiography: the lower right lung field visible stripe shadow, blurred edges, sacroiliac joint film (anteroposterior position): both sides of the sacroiliac joint surface whitening, blurred, increased density, and see the left