2012 12 32 12 1001-6325 2012 12-1492 -07 December 2012 Vol. 32 No. 12 50 1 100032 R 563. 5 R 542. 5 + 3 A 45 1 1 1. 1 2011 7 16 1995 7 Tmax 41. 0 1 h 90 30 ~50 ml < > 1 ~ 2 8 ~ 1 30 WBC /d 20 4 /d 20 10. 3 ~ 20. 5 10 9 /L GR 68% ~ 85% Hgb 10. 3 ~ 12. 5 g /dl PLT 128 ~ 276 10 9 /L ESR 28 mm / 1sth CXR 2 8-25 7 4 kg 1. 2 T 37 P 70 / R 19 / BP 125 / 8 9 76 mmhg SpO2 92% @ RA 10 251 WBC 11. 82 10 9 /L HGB 2 /6 144 g /L PLT 128 10 9 /L - 10 cm CT 8 ~ 10 1 / * 1 1. 3 3 d 1. 3. 1 WBC 10. 73 10 9 /L LY% 19. 3% HGB 106 g /L PLT 566 10 9 /L 100 ~ 200 ml /d ALT 127 U /L GGT 70 U /L ALP 31 U /L CT 8-18 AST 44 U /L Alb 34 g /L - ABG @ RA 2012-07 - 16 2012-07 - 17
1 1493
1494 2012. 32 12 ph 7. 446 PCO2 37. 0 mmhg PO 2 76. 4 mmhg HCO 3 25 mmol /L Lac 1. 0 mmol /L PT 12. 9 s INR 1. 08 Fbg 6. 63 g /L APTT 31. 6 s D-dimer 298 μg /L ESR 101 mm /1sth hscrp 73. 1 mg /L 1. 3. 2 BST PCT TORCH - 5 - TB-SPOT 32SFC /10 6MC TB - - + 1. 3. 3 CA - NSE 18 ng /ml TPA 1. 59 ng /ml 1. 3. 4 ANA - ENA - ANCA - 8 31 1. 3. 5 8 ~ 29 1 g q12h + 1. 2 g q8h 2 d 9 mm 14 mm Tmax < 37. 5 LVEF 68% HRCT + CTPA + CTV 9-1 3 4 2011-08-18 L > R 1. 4 8 25 1 g q12h + 0. 6 g qd 8 25 8 29 37 ~ 38 8 30 Tmax 40. 2 9-5 3 Fig 3 HRCT 2011-09-01 Chest HRCT 2011-09-01
1 1495 4 Fig 4 CTPA 2011-09-01 CTPA 2011-09-01 2 5 mm SPE 2011-09-06 SPE 1 + 2 3 4 + - - 10 d 9-13 LVEF 60% ANCA - NACA - 2 2. 1 1 CTPA 1 5% ~ 10% 1 ICD
1496 2012. 32 12 2. 4 2 5 3 4 ~ 6 6 3 2. 2 2011-08-10 CT 5 HE Fig 5 2011-08-18 CT 8 CT infective endocarditis IE IE 2 ~ 3 1 IE 2 2011-09-01 4 CTPA + CTV 1 2011-08-18 CTV 2011-10-08 HRCT 1 2. 3 Pathology of tricuspid valve 2. 5 2 90%
1 1497 4 ~ 6 6 5 27 5 43 13 49 > 1 cm 28 CNS 7 2 Ⅱ ~ Ⅲ Ⅳ 6 4 ~ 6 16 71 2. 6 5 25 d /18 d 2. 7 20 1990 1999 4 2000 2009 11 2010 5 = 14 6 19 ~ 71y < 20y 2 20 ~ 49y 14 > 50y 4 6 5 1 2 AA 2 1 3 2 ~ 3 cm IE IE 19 18 16 16 17 17-8 2 1 Ⅲ ~ Ⅳ 2 > 4 5 10 cm 3 8 7 3 4 1 1 1 CXR 4 CT 19 6 5 7 2 2 2 PE 3 V /Q 7 CTPA 10 IE IE 2 ~ 4 4 ~ 3 > 1 6 IE 1 10 4 6 85% 4 < + 20% 1 12 2. 8% 1 98% 5 92. % 10 79% 5 1 ~ 1 20 18 2 1 1 3 > 1 3 2001 2010 IE 293 15 78 71 10 1 4
1498 2012. 32 12 PE 3 2 1 SPE 1 3 2 3 0. 4 Qd po + 0. 625 g bid po INR 2. 5 SPE CTPA + CTV 2011-10-13 1 WebMD 2012-02-12 Claudia E. Kuehni 12 1 500 1 8 ~ 14 4 Roya Samuels American Journal of Respiratory and Critical Care Medicine WebMD 2012-02-06 4 TNF 50 FDA TNF FDA 11 30 30 JIA UAB 7 800 JIA 2000 2005 65 32 ADHD JIA 4. 4 TNF Enbrel Arthritis & Rheumatism