病例男,44岁,住院号1268。患者于20岁时自觉疲乏无力和周身不适,并发现巩膜、皮肤黄染,按黄疸型肝炎收入当地医院治疗。在此后20年里,常因感冒和劳累后出现巩膜、皮肤黄染加深并多次就诊,均按肝炎进行治疗。发病以来虽然多次出现黄疸加深,但都无明显消化道症状。1989年5月,以反复出现黄疸23年为主诉,就诊当地医院,按慢性活动型肝炎转来我院住院。后经追述病史,明确发现黄疸加重都在劳累,饮酒或感冒后出现,没有厌油腻、恶心、呕吐、腹胀、肝区痛等症状。家族史中母健康,父有黄疸病史,同胞4人.弟12岁,妹19岁起均发现巩膜黄染,至今未退。查体:一般状况良好,巩膜及皮肤明显黄染,未见蜘蛛痣和肝掌,亦无面部血管扩张和出血倾向,更无慢性肝病容。心肺正常,肝区无叩痛,胆囊区无触痛和压痛,肝右肋下锁骨中线上扪及边缘,脾未触及。实验室检查:血总胆红素850 mmol/L,直接胆红素51mmol/L,间接胆红素799 mmol/L,黄疸指数27U。SGPT正常,乙肝 Case Male, 44 years old, hospital number 1268. Patients at the age of 20 were consciously weak and unwell, and found sclera, skin yellow dye, according to jaundice hepatitis treatment at the local hospital. In the next 20 years, often due to cold and fatigue after the sclera, yellow skin dye deepen and multiple visits, are treated by hepatitis. Although the incidence of jaundice since many times deepen, but no obvious gastrointestinal symptoms. May 1989, with repeated jaundice 23 years as the main complaint, visit a local hospital, according to chronic active hepatitis transferred to our hospital. After the recovery of medical history, jaundice was clearly found in the increase are tired, after drinking or cold, no greasy tired, nausea, vomiting, abdominal distension, liver pain and other symptoms. Family history of the mother of health, the father had a history of jaundice, siblings 4. Brother 12 years old, 19-year-old girl were found scleral yellow dye, has not withdrawn. Examination: The general condition is good, the sclera and the skin is obviously yellow dye, no spider nevus and liver palms, no facial vasodilation and bleeding tendency, no more chronic liver disease. Coronary heart and lungs, no percussion pain in the liver area, no tenderness and tenderness in the gallbladder area, palpable margins on the midline of the right subcostal clavicle, the spleen not touched. Laboratory tests: blood total bilirubin 850 mmol / L, direct bilirubin 51mmol / L, indirect bilirubin 799mmol / L, jaundice index 27U. SGPT normal, hepatitis B.