论文部分内容阅读
病历摘要患者男,36岁。多饮、多尿、多食伴消瘦16年;不规则发热4年.患者于1965年12月曾因头昏、乏力、贫血入本院诊治,入院后经骨穿诊断为单纯性红细胞再生障碍性贫血,经多次输血(总量达3万ml),住院一年治愈。住院时查血清铁123μg%,铁结合力336μg,铁饱和度37%,尿含铁血黄素+。住院期间曾一度发生黄疽及肝功能损害。经保肝及强地松治疗2月后症状逐步改善,肝功能正常.出院后继服强地松,于1967年7月在撤强地松的过程中出现烦渴、多饮、多尿、多食,查血糖436mg%,尿糖卅,确诊为糖尿病,用胰岛素治疗。1978年5月查肝功能正常,食道吞钡检查示食道下段轻度静脉曲张。1979年1月出现间歇、不规则的畏寒、发热、体温高达39.5℃,持续8～9小时后可自行恢复正常。发热间歇长短不一,无明显规律。曾多方治疗无效,病人日趋软弱、消瘦,于1983年4月26日再次收住院。
Patient summary Male, 36 years old. Drink more, polyuria, eat more food with weight loss 16 years; irregular fever 4 years .In December 1965 patients had dizziness, fatigue, anemia into the hospital for diagnosis and treatment, admitted to the bone after the diagnosis of simple red cell aplasia Anemia, after repeated blood transfusions (a total of 30,000 ml), hospitalized a year to cure. Check hospital serum 123μg% iron, iron binding 336μg, iron saturation 37%, urinary hemosiderin +. Jaundice and liver damage occurred once during the hospital stay. After the treatment of hepatoprotective and prednisone 2 months after the symptoms gradually improved, normal liver function.After discharge from the hospital strong pine, in July 1967 in the process of withdrawal of strong pine polydipsia, polydipsia, polyuria, and more Food, check blood sugar 436mg%, urine sugar, diagnosed with diabetes, insulin treatment. May 1978 check liver function is normal, esophageal barium swallow showed mild esophageal varices. January 1979 intermittent, irregular chills, fever, body temperature up to 39.5 ℃, sustained 8 to 9 hours after the return to normal on their own. Intermittent fever varies in length, no obvious regularity. Has multi-treatment ineffective, the patient is increasingly weak, weight loss, on April 26, 1983 again admitted to hospital.