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病例10岁,男。近4个月来有易疲劳、食欲减退症状。5天前因发热、咳嗽就医,发现腹部胀满和胸部X线有异常阴影。平素健康。其父患肝硬化、叔父患慢性肝炎,祖父因胰腺癌死亡。父、母、兄HBsAg、HBeAg均阳性。入院时其身长14.58cm、体重40.6kg、体温38.8℃、脉搏144次/分、呼吸26次/分、血压122/60mmHg。皮肤和球结膜轻度黄染,前胸及腹壁表浅静脉明显怒张。肺肝界5肋间,肝右季助下13cm可触及,表面凹凸不平呈弹性硬、有压痛、脾肋下6cm可触及。无腹水和浮肿征。外周血白细胞数稍增高、骨髓象正常。血清白蛋白稍低、IgA、IgG升高,肝功能示轻度异常,甲种胎儿球蛋白异常增高(290.000ng/ml),血清铁蛋白升高。
Case 10 years old, male. Nearly 4 months have fatigue, loss of appetite symptoms. 5 days ago due to fever, cough and medical treatment, found abdominal fullness and chest X-ray abnormal shadow. Usually healthy. His father suffering from cirrhosis, uncle suffering from chronic hepatitis, grandfather died of pancreatic cancer. Parent, mother, brother HBsAg, HBeAg were positive. At admission, the body length 14.58cm, weight 40.6kg, body temperature 38.8 ℃, pulse 144 beats / min, breathing 26 beats / min, blood pressure 122 / 60mmHg. The skin and conjunctiva mild yellow dye, chest and abdominal superficial vein was obviously engorgement. Pulmonary and hepatic 5 intercostal, right hepatic 13cm can be touched under the aid of the season, the surface is elastic and elastic, tenderness, spleen 6cm under the ribs can be touched. No ascites and edema sign. Peripheral blood leukocytes slightly increased, bone marrow as normal. Slightly lower serum albumin, IgA, IgG increased, showed mild abnormal liver function, abnormal increase in fetal globulin (290.000ng / ml), elevated serum ferritin.