患者男,62岁。因血尿伴四肢大片淤斑2周入院。患者1987年8月24日,因“感冒”2天自服复方新诺明8片。次日起四肢内侧及臀部皮肤发现大片淤斑,皮肤稍损伤即出血,数小时才停止。同日出现无痛性肉眼血尿,尿量正常,无腰酸、发热和尿急、尿痛等,无肌肉关节肿胀、出血和活动障碍。曾在门诊给予凝血酶原复合物静滴,环磷酰胺,强的松口服,出血症状无明显改善,于1987年9月入院。患者无自幼出血史,家属无出血史。以往拔牙和外伤均无出血不止现象。否认有药物过敏史。有“血压偏高”,“心律不齐”和肝肿大的病史数年。体检:血压156/88,神志清楚,呼吸平稳,双侧瞳孔无特殊,咽(—),颈软,气管居中,颈、锁骨上淋巴结未触及,两肺呼吸音清,左肺背侧少量罗音。心率80,律齐,未闻及病理性杂音。腹平软,肝脾肋下未及,肝剑突下3.5cm,质 Male patient, 62 years old. Due to hematuria with limbs ecchymosis 2 weeks admission. Patients August 24, 1987, due to “cold” self-serving compound Novolin tablets 8 tablets. The next day the inner limbs and buttocks skin found large ecchymosis, skin lesions that bleeding, a few hours before stopping. The same day there painless gross hematuria, normal urine output, no backache, fever and urgency, dysuria, muscle swelling, bleeding and movement disorders. Once in the clinic to give intravenous infusion of prothrombin complex, cyclophosphamide, prednisone oral, no significant improvement in bleeding symptoms, admitted in September 1987. No history of bleeding in patients with a history of family history of bleeding. In the past no tooth bleeding and traumatic bleeding more than the phenomenon. Denied a history of drug allergies. Have “high blood pressure”, “arrhythmia” and hepatomegaly history for several years. Physical examination: blood pressure 156/88, consciousness clear, bilateral pupil no special, pharyngeal (-), neck soft, tracheal center, neck, supraclavicular lymph nodes not touched, lung breath sounds clear, a small amount of left lung dorsal sound. Heart rate 80, law Qi, no smell and pathological murmur. Abdomen soft, liver and spleen ribs, liver xiphoid 3.5cm, quality