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例1 女,21岁,乏力、纳差,尿黄15天于1989年9月19日入院,无服氯霉素史。查体:T 36.4℃,巩膜皮肤深度黄染,心肺叩听未见异常,腹平软,肋下未及肝脾,腹水征(+)。实验室检查;血红蛋白130g/L,红细胞4.5×10~(12)/L,白细胞6.4×10~9/LN 0.64 L0.33血清胆红质(SB)102μmol/L血清丙氨酸转氨酶(ALT)49u,凝血酶元时间(PT)14秒(对照14秒)。HBVM六项标志(-),抗HAV-IgM(+)。临床诊断:病毒性肝炎、甲型、急性黄疸型。入院后给保肝等治疗。起病第17日起出现持续性发热(T37.8～40℃),用抗菌素治疗无效,一周内Hb从130g/L降至30g/L,网织红细胞0.5%,黄疸加深。第31病日肝穿刺病理诊断:急性肝炎。骨髓相:有核细胞增生
Example 1 Female, 21 years old, weakness, anorexia, urine yellow 15 days in September 19, 1989 admission, no history of chloramphenicol. Physical examination: T 36.4 ℃, scleral skin depth yellow dye, no abnormal cardiopulmonary percussion hearing, abdominal soft, ribs and liver and spleen, ascites (+). Laboratory tests showed that hemoglobin 130g / L, erythrocytes 4.5 × 10-12 / L, white blood cells 6.4 × 10-9 / LN 0.64 L0.33 serum bilirubin (SB) 102μmol / L serum alanine aminotransferase (ALT) 49u, thrombin time (PT) 14 seconds (control 14 seconds). HBVM six markers (-), anti-HAV-IgM (+). Clinical diagnosis: viral hepatitis, A, acute jaundice. Admission to the liver and other treatment. On the 17th onset onset of persistent fever (T37.8 ~ 40 ℃), with antibiotic treatment ineffective, within a week Hb from 130g / L to 30g / L, reticulocyte 0.5%, jaundice deepened. Day 31 liver biopsy pathological diagnosis: acute hepatitis. Bone marrow phase: nucleated cell proliferation