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张某,男,56岁。1981年4月28日。自诉感冒,发冷,体温38℃。在本院门诊部3天内肌注安痛定7支,并用青、链霉素3天。第三天体温正常,但四肢远端皮肤出现紫癜,舌尖部出现瘀斑,逐日加重,并有鼻衄及牙龈出血。5月4日化验:白细胞1,700,中性2%,淋巴94%,嗜酸4%,血红蛋白10克,血小板2.9万。出血时间3分,凝血时间4分。骨髓检查:骨髓增生极度低下,淋巴细胞82%,浆细胞5%,嗜酸细胞10%,晚幼红细胞1%,网织细胞1%。收住院诊治。既往身体健康,否认药物过敏史,曾间断服去痛片。体检:体温37℃,血压170/100。轻度贫血面容。全身皮肤有散在紫癜及大小不等之瘀斑,以下肢远端皮肤为著。表浅淋巴结不大。鼻前庭有血痂,牙龈渗血,软腭有针尖大小出血点。心尖部闻Ⅲ级
Zhang, male, 56 years old. April 28, 1981 Prosecute cold, cold, body temperature 38 ℃. In our hospital clinic 3 days intramuscular injection of analgesic given 7, and blue, streptomycin 3 days. The third day the body temperature was normal, but the extremity skin purpura appears on the tongue, tongue ecchymosis, increasing day by day, and epistaxis and bleeding gums. May 4 test: 1,700 leukocytes, 2% neutral, lymph 94%, 4% eosinophilic, 10 grams of hemoglobin, platelets 29000. Bleeding time 3 minutes, clotting time 4 points. Bone marrow examination: myeloproliferation is extremely low, 82% of lymphocytes, 5% of plasma cells, 10% of eosinophils, 1% of young erythrocytes and 1% of reticulocytes. Admitted to hospital for treatment. Past physical health, denied the history of drug allergies, had intermittent service pain tablets. Physical examination: body temperature 37 ℃, blood pressure 170/100. Mild anemia. Whole body skin scattered in purpura and ecchymosis ranging from the size of the lower limb to the distal skin. Superficial lymph nodes is not large. Nasal vestibule with blood scab, gum oozing, soft palate tip size bleeding point. Apex smell smell Ⅲ