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患者男,68岁。因反复上腹痛伴反酸、暖气30年,复发加重7天,于1986午5月17日入院。1984年作胃镜示:十二指肠球部溃疡。1978年患前列腺增生症。无肝病史。体检:皮肤巩膜无黄染。中上腹偏右轻压痛,肝胆脾不肿大。麝浊4u、锌浊10u、GPT36u,总胆红素(TB)12μmol/L,直接胆红素(DB)3.4μmol/L,HBsAg(一),AFP(一),A/G=1.8:1,AKP12u,尿二胆(一)。B超示肝胆胰脾正常。给予雷尼替丁150mg,每日2次,服药第九天始感皮肤略搔痒,1个月时搔痒甚。皮肤巩膜黄染,肝肋下1.5cm,脾肋下恰及,胆囊不大。麝浊5u,锌浊10u,GPT196u,TB58.1μmol/L,DB25.7μmol/L,HBsAg(一),凡登白直接反应(+),AKP34u,胆固醇7.42mmol/L,γ-GT94u,尿胆红素(+),尿胆原减少,粪色浅淡。凝血酶原时间16秒,注射
Male patient, 68 years old. Due to repeated upper abdominal pain with acid reflux, heating for 30 years, recurrence increased seven days, in 1986 May 17 admission. Gastroscopy in 1984 showed: duodenal ulcer. In 1978 suffering from benign prostatic hyperplasia. No history of liver disease. Physical examination: skin sclera without yellow dye. In the upper abdomen soft right tenderness, hepatobiliary spleen is not enlarged. (A), AFP (a), A / G = 1.8: 1, and the ratio of GPT36u, total bilirubin (TB) 12μmol / L, direct bilirubin 3.4μmol / L, HBsAg , AKP12u, urinary bile (a). B ultrasound showed hepatobiliary and pancreatic normal. Give ranitidine 150mg, 2 times a day, the first nine days of medication feel the skin is itchy, very scratchy at 1 month. Skin sclera yellow dye, liver rib 1.5cm, spleen ribs, gall bladder is not. (+), AKP34u, cholesterol 7.42mmol / L, γ-GT94u, urinary bile Red (+), reduce urinary gallstones, dung color pale. Prothrombin time 16 seconds, injection