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患者,男性,61岁。纳差、乏力25年,发现胸椎旁阴影2年,反复发作性左上腹痛10天,于84年10月9日入院。既往无高血压病史。体检:T36.8℃,R22次/分,BP140/80mmHg。皮肤可见蜘蛛痣,淋巴结不肿大,巩膜稍黄染。颈静脉不怒张,气管居中。右下肺少量细湿罗音,心浊音界不扩大,心率97次/分,律齐,A_2>P_2,心尖部闻及Ⅱ级吹风样杂音。腹软,无压痛,未及包块,肝肋下未及.脾肋下3.0Cm,质中等,无触痛,移动性浊音十,腹部无血管杂音。下肢无水肿,双侧足背动脉搏动好,腱反射正常。实验室检查;Hb10.5g/dl、WBC4.1×10~9/L、N73％、L23％,血小板5.4×10~9/L。粪潜血(-)。SGPT140~u,HBsAg+,总胆红质2.17mg％,直接
Patient, male, 61 years old. Anorexia, 25 years of fatigue, found that the thoracic paravertebral shadow 2 years, recurrent left upper abdominal pain for 10 days, on October 9, 84 admitted. No previous history of hypertension. Physical examination: T36.8 ℃, R22 times / min, BP140 / 80mmHg. Spider nevus visible on the skin, lymph nodes are not swollen, scleral slightly yellowed. Jugular vein does not rage, tracheal center. A small amount of right lower lung fine wet rales, heart dullness is not expanding, heart rate 97 beats / min, law Qi, A_2> P_2, apical smell and Ⅱ grade hair-like noise. Abdominal tenderness, no tenderness, not mass, liver and ribs under. Spleen ribs 3.0Cm, medium quality, no tenderness, mobility dullness ten, abdominal vascular murmur. Lower extremity without edema, bilateral dorsalis pedis artery pulsation, tendon reflexes normal. Laboratory tests; Hb10.5g / dl, WBC4.1 × 10 ~ 9 / L, N73%, L23%, platelets 5.4 × 10 ~ 9 / L. Cathartic occult blood (-). SGPT140 ~ u, HBsAg +, total bilirubin 2.17mg%, directly