贫血是由多种原因引起的一种综合征,及早明确贫血原因是进行合理而及时治疗的关键。本文拟通过几例谈谈诊断体会及误诊教训,以期引起重视。【例1】女,28岁,社员。4～5年来面色苍白、头晕、全身乏力,每于月经后加重。经常用维生素B_(12)、叶酸(未用铁剂)无效。4天前因分娩(第三胎)流血较多,上述症状加重伴心悸、气短,有时恶心、呕吐。发病以来无发冷、发热、呕血、便血、皮肤粘膜出血。体检:体温36℃,血压110/80毫米汞柱。神志清楚,面色苍白,面部略浮肿,巩膜不黄染,表浅淋巴结不大,胸骨压痛(一)。心尖部可闻及Ⅱ级收缩期杂音,肺部正常,腹平软,肝脾未触及。其他无异常。实验室检查:血红蛋白3.0克%,红细胞98万%,网织红细胞0.2%,白细胞5,100/立方毫米,中性70%,淋巴28%,单核2%。血小板16万/立方毫米。尿常规(一),便 Anemia is caused by a variety of causes of a syndrome, as early as possible causes of anemia is the key to reasonable and timely treatment. This article intends to talk about a few cases of diagnostic experience and misdiagnosis lessons, with a view to attracting attention. [Example 1] Female, 28 years old, member. 4 to 5 years pale, dizzy, malaise, increased after menstruation. Often with vitamin B_ (12), folic acid (without iron) is invalid. 4 days ago because of childbirth (third) bleeding more, the above symptoms aggravated with palpitations, shortness of breath, and sometimes nausea and vomiting. Since onset no chills, fever, hematemesis, hematochezia, skin and mucous membrane bleeding. Physical examination: body temperature 36 ℃, blood pressure 110/80 mm Hg. Conscious, pale, slightly swollen face, sclera not yellow, superficial lymph nodes, sternal tenderness (a). Apex can be heard and Ⅱ systolic murmur, normal lungs, abdominal soft, liver and spleen not touched. No other abnormalities. Laboratory tests: hemoglobin 3.0 g%, red blood cells 980000%, reticulocyte 0.2%, white blood cells 5,100 / cubic millimeter, neutral 70%, lymphatic 28%, mononuclear 2%. Platelets 160,000 / cubic millimeter. Urine routine (a), then